Data Analysis Flashcards
6 cards from real CCDS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Data Analysis flashcards as text
A CDI manager wants to benchmark their hospital's CMI against peer institutions. Which data source is MOST appropriate?
Answer: CMS Provider of Services file or Hospital Compare data
CMS publicly reports CMI and other performance data through Hospital Compare and the Provider of Services file, enabling hospitals to benchmark themselves against peers of similar size, type, and geographic region.
When analyzing CC/MCC capture rates by physician, a CDI analyst finds that one physician has a significantly lower capture rate than peers. What is the MOST appropriate next step?
Answer: Conduct a focused chart review to determine if documentation gaps or coding issues are the cause
Before taking any action, the CDI analyst should conduct a focused review of the physician's charts to determine whether the low capture rate reflects documentation deficiencies, a legitimately less-complex patient mix, or coding issues.
Which statistical measure is BEST used to identify outlier cases where actual LOS far exceeds the expected LOS for the assigned DRG?
Answer: Standard deviation from the Geometric Mean Length of Stay (GMLOS)
Comparing actual LOS against the GMLOS using standard deviation identifies statistical outliers where the actual stay significantly exceeds what is typical for that DRG.
A CDI program is evaluating its query impact. Which metric DIRECTLY measures the financial effect of CDI activities?
Answer: Revenue per query or DRG shift value
Revenue per query or DRG shift value directly quantifies the financial impact of CDI activities by calculating the dollar value of DRG weight changes resulting from documentation improvements.
In a CDI data analysis, 'DRG pairs' are used to:
Answer: Identify diagnosis groups where documentation of a CC or MCC would change the DRG assignment
DRG pairs or triplets are groups of related DRGs where the same base diagnosis results in different DRG assignments depending on whether a CC or MCC is documented. CDI specialists use DRG pair analysis to identify high-opportunity cases.
A hospital notices its observed mortality rate is significantly higher than the expected rate for pneumonia patients. The CDI manager suspects documentation deficiency. What is the MOST likely gap?
Answer: Secondary diagnoses that capture patient complexity are not being documented
When observed mortality exceeds expected mortality, it often indicates that secondary diagnoses reflecting patient complexity such as MCCs are not being documented. Without these diagnoses, the risk-adjustment model underestimates expected mortality.