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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Anatomy and physiology, pathophysiology, pharmacology, and medical terminology | 19.17% | - Clinical conditions and clinical indicators - Anatomy, physiology, pathophysiology, pharmacology, and terminology |
| Topic 2: Impact of reportable diagnoses on quality of care | 8.33% | - Quality metrics, reporting programs, and financial impact - Mortality, severity of illness, and risk of mortality |
| Topic 3: Professionalism, ethics, and compliance | 9.17% | - Confidentiality, DRG compliance, and ethical CDI practices - Query compliance, DRG creep, and audit risks |
| Topic 4: Medical record documentation | 19.17% | - Documentation requirements and diagnosis or procedure code assignment - Documentation clarification and compliant physician queries |
| Topic 5: Official Guidelines for Coding and Reporting | 14.17% | - Coding guidelines, AHA Coding Clinic, HACs, and POA indicators - Principal and secondary diagnosis assignment |
| Topic 6: Healthcare regulations, reimbursement, and documentation requirements related to the IPPS | 12.5% | - IPPS, MS-DRGs, reimbursement, and medical necessity - CC/MCC, CMI, Medicare contractors, and compliance |
| Topic 7: Healthcare facility CDI program analysis | 8.33% | - Data analysis, forecasting, and performance measurement - CDI productivity, provider response, CMI, and program metrics |
| Topic 8: Communication skills | 9.17% | - CDI and coding roles and interdisciplinary collaboration - Physician education and effective communication |
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148. Frage
The attending physician documents acute respiratory failure. The patient has normal respiratory effort, oxygen saturation of 97% on room air, no supplemental oxygen requirement, and no ventilatory support. What is the MOST appropriate CDI action?
Antwort: B
Begründung:
This is a classic clinical validation query scenario. A diagnosis has been documented, but the available clinical evidence appears inconsistent with or insufficient to support that diagnosis.
The CDI specialist should not independently delete acute respiratory failure, substitute another diagnosis, or direct coding personnel to disregard provider documentation without an appropriate clarification process.
Instead, the query should objectively present the relevant clinical findings-normal respiratory effort, room- air oxygenation, absence of escalating oxygen requirements, and absence of ventilatory support-and ask the provider to clarify the diagnosis.
The provider may confirm respiratory failure and document additional clinical reasoning, revise the diagnosis, identify another condition, or state that the diagnosis was ruled out. The CDI specialist's responsibility is to support record integrity, not to replace provider clinical judgment.
The official CCDS content outline specifically requires candidates to understand mechanisms for addressing diagnoses lacking clinical support and to distinguish compliant from noncompliant queries. The current 2026 ACDIS/AHIMA guidance is the foundational query-practice standard.
CCDS Reference Topics: Clinical validation; respiratory failure; unsupported diagnoses; compliant query practice; documentation integrity.
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149. Frage
Respiratory failure is documented in a patient's initial progress notes. There are no clinical indicators in the record to support this diagnosis. According to the AHIMA/ACDIS Practice Brief Guidelines for Achieving a Compliant Query Practice, the MOST appropriate action by the CDI specialist is which of the following?
Antwort: A
Begründung:
This scenario requires a clinical validation query. The diagnosis of respiratory failure is documented, but the remainder of the record lacks clinical evidence supporting it. CDI should not automatically accept the diagnosis solely because it appears in a progress note, nor should the specialist unilaterally remove or invalidate the provider's diagnosis.
The appropriate process is to present relevant patient-specific clinical information objectively and ask the responsible provider to clarify whether respiratory failure remains clinically appropriate. A compliant validation query should permit the provider to confirm the diagnosis, document another condition, indicate that it was ruled out, or provide another clinically appropriate response.
Looking only for CPAP documentation is inadequate because CPAP can be used for multiple conditions and its presence or absence does not independently determine whether respiratory failure exists. Similarly, simply refusing to code the diagnosis without seeking clarification bypasses the provider's clinical judgment and the organization's validation process.
The 2026 ACDIS/AHIMA query guidance is now the current foundational standard and supersedes earlier versions of the practice brief.
CCDS Reference Topics: Clinical validation; compliant querying; unsupported diagnoses; documentation integrity.
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150. Frage
A hospital has 2,500 inpatient discharges and a cumulative MS-DRG relative weight of 4,375. What is the hospital's case mix index?
Antwort: A
Begründung:
Case mix index is calculated as:
Total MS-DRG relative weights ÷ Total inpatient discharges
Therefore:
4,375 ÷ 2,500 = 1.75
The hospital's CMI is 1.75.
CMI provides an aggregate indication of the average relative resource intensity of the hospital's inpatient population. Because each MS-DRG carries a relative weight, hospitals treating larger numbers of complex medical or surgical cases typically have higher CMIs than hospitals treating less resource-intensive populations.
CMI is not a direct quality score and should not be interpreted as a pure measure of CDI performance. It can change because of service-line mix, surgical volume, patient acuity, transfers, annual MS-DRG recalibration, coding accuracy, documentation quality, and other operational changes.
CMS maintains the FY 2026 MS-DRG Definitions Manual and grouper logic, currently Version 43.1 for April 1 through September 30, 2026.
A CDI manager should therefore analyze unexpected CMI changes alongside service-line trends, query activity, coding reconciliation, procedure volumes, and diagnosis patterns.
CCDS Reference Topics: CMI; relative weights; CDI analytics; MS-DRGs; trend analysis.
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151. Frage
A hospital records 72 observed deaths, while its risk-adjustment model predicts 90 expected deaths. What is the observed-to-expected mortality ratio?
Antwort: D
Begründung:
Observed-to-expected mortality is calculated as:
Observed deaths ÷ Expected deaths
Therefore:
72 ÷ 90 = 0.80.
An O/E ratio of 0.80 means that observed mortality was lower than predicted by the applicable risk- adjustment model. Specifically, observed deaths were 20% below the expected number.
A ratio of 1.0 indicates observed mortality equals expected mortality. Values above 1.0 indicate more deaths than predicted, while values below 1.0 indicate fewer deaths than predicted.
CDI influences the integrity of mortality analysis because the documented disease burden contributes to clinical data used by many risk-adjustment methodologies. If significant comorbidities are incompletely documented, expected mortality may not fully reflect the patient's clinical risk.
However, mortality review must never become a mechanism for adding unsupported diagnoses. The objective is accurate clinical representation.
The CCDS candidate handbook explicitly identifies data analysis, reporting functions, medical-record review, and the impact of documentation on clinical and administrative outcomes as important CDI competencies.
CCDS Reference Topics: Mortality index; O/E ratio; risk adjustment; quality reporting; CDI analytics.
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152. Frage
A hospital reports 80 observed deaths when its risk-adjustment methodology predicted 100 expected deaths.
What is the observed-to-expected mortality ratio, and what does it indicate?
Antwort: D
Begründung:
The observed-to-expected mortality ratio is calculated as:
80 observed deaths ÷ 100 expected deaths = 0.80.
A ratio below 1.0 means observed mortality is lower than predicted. In this case, the number of observed deaths is 20% below the expected number.
Accurate interpretation of mortality data is important for CDI because documentation contributes to the clinical information used by many risk-adjustment methodologies. If significant comorbidities or acute conditions are inadequately documented, the coded record may not fully represent the patient's severity or mortality risk.
However, CDI professionals must avoid treating risk-adjustment improvement as justification for unsupported diagnoses. Documentation should accurately represent conditions that were clinically present, evaluated, treated, monitored, or otherwise reportable according to applicable rules.
The official CCDS content outline specifically includes severity of illness/risk of mortality, physician documentation effects on public reporting, and analysis of hospital performance among its expected competencies.
Mortality ratios should also be interpreted in context; they are influenced by patient population, model methodology, documentation, coding accuracy, and actual clinical outcomes.
CCDS Reference Topics: O/E mortality; ROM; risk adjustment; quality outcomes; CDI program analysis.
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153. Frage
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Dass man das Zertifikat für ACDIS CCDS erhalten kann, wird die Voruassetzung dafür, dass man in der immer schärf konkurrierten IT-Branche weiter entwickeln kann. Es ist durchaus machbar, dass man anhand der Fragenkataloge zur ACDIS CCDS Zertifizierungsprüfung von ZertSoft diese Prüfung so schnell wie möglich besteht. Wir versprechen Ihnen, dass wir Ihnen alle Ihre bezahlten Summe zurückgeben werden, wenn Sie die ACDIS CCDS Zertifizierungsprüfung nicht bestehen, nachdem Sie unsere Fragenpool gekauft haben.
CCDS Zertifikatsfragen: https://www.zertsoft.com/CCDS-pruefungsfragen.html