Which statement best describes the function of CDI teams?

Which statement best describes the function of CDI teams?

• A. They assign CPT codes directly to claims.
• B. They review records to ensure documentation supports the coded diagnoses and procedures, prompting clinicians to add detail.
• C. They handle patient billing questions.
• D. They audit physician schedules.

Answer: (B)

CDI teams focus on making sure the clinical documentation aligns with the codes used. Their job is to review the medical record to confirm that the documented diagnoses and procedures are adequately supported by the chart, and to prompt clinicians to add detail or clarification when the documentation is incomplete or vague. This helps ensure the codes chosen later have solid justification, improving accuracy in coding and reimbursement. They don’t assign CPT codes directly to claims—the coding professionals do the actual coding after the documentation is sufficiently detailed. They also don’t handle patient billing questions or audit physician schedules. For example, if a chart notes an infection without specifying the site or severity, a CDI query would seek those details so the right codes reflect the patient’s reality. This focused review and clarification process supports accurate coding, proper DRG assignment, and compliant billing.

CDI teams focus on making sure the clinical documentation aligns with the codes used. Their job is to review the medical record to confirm that the documented diagnoses and procedures are adequately supported by the chart, and to prompt clinicians to add detail or clarification when the documentation is incomplete or vague. This helps ensure the codes chosen later have solid justification, improving accuracy in coding and reimbursement.

They don’t assign CPT codes directly to claims—the coding professionals do the actual coding after the documentation is sufficiently detailed. They also don’t handle patient billing questions or audit physician schedules. For example, if a chart notes an infection without specifying the site or severity, a CDI query would seek those details so the right codes reflect the patient’s reality. This focused review and clarification process supports accurate coding, proper DRG assignment, and compliant billing.