Note from the Associate Editorial Director: Early query data from the 2024 Industry Survey, your experience wanted!

by Linnea Archibald

Queries are at the heart of CDI work and for the first time in several years, we’ve included a special focus on query practice and metrics in the 2024 CDI Week Industry Survey. Though the survey remains open until Friday, July 19, (and we’d love your continued responses!), I wanted to take a moment to share some of the preliminary findings to whet your appetite. Note that the full results, along with expert commentary, will be published during CDI Week this year, which will take place September 16-20.

When ACDIS last conducted a survey focused on queries in 2019, it found that nearly 59% of respondents had a query response rate of 91%-100%, up nearly 20 percentage points from the last query survey conducted in 2017. According to the early results from the 2024 CDI Week Industry Survey, that high level of provider engagement with queries has remained constant and even grown: 73.44% of respondents said their query response rate fell in the 91%-100% range.

It's possible that the high provider response rate reported by 2024 CDI Week Industry Survey respondents is linked to the fact that the vast majority of respondents (87.50%) also stated that they have an escalation policy in place that requires providers to respond to queries.

Though query response rates have continued to rise over the years, query agree rate (defined in the survey as a written response on a query form or in the record that provides clarity to apply a new or more specific code or provides clinical validation of a documented condition) has remained nearly flat. The largest group in 2019 (39.67%) fell into the 91%-100% agree rate bracket; in 2024, just over 40% have fallen into the same category.

Interestingly, early 2024 CDI Week Industry Survey results also show a marked increase in the query rates—i.e., the percentage of charts that have at least one query opportunity found during CDI review—than was expected according to respondents to the 2017 query survey. In 2017, the largest portion of respondents (16.51%) said they expected their staff to query on 21%-25% of cases reviewed, followed by 10.48% who said they expected their staff to query on 26%-30% of cases reviewed. In contrast, according to the 2024 survey, the largest portion of respondents (29.69%) said their staff query on 31%-40% of cases reviewed, followed by 21.09% who said that staff query on 21%-30% of cases reviewed.

While these query rates could raise alarm bells—providers have had years of exposure to CDI education and efforts, is their documentation really still in need of clarification?—it’s likely that the queries being sent today are often focused on more complex issues than their predecessors. Expanded CDI responsibilities in the realm of quality, denials management, and more means that CDI staff are looking at more factors than simply capturing CCs and MCCs for DRG accuracy.

The advent of technology (which will be explored in more detail in the full 2024 CDI Week Industry Survey report) has also likely freed up CDI time to focus on those more complex query opportunities. In fact, early 2024 results show that 61.46% of respondents feel that technology has helped identify “low-hanging fruit” queries so CDI staff can focus on more complex issues or expanded reviews.

Though these stats are based on incomplete early survey findings, I hope they’ve piqued your interest in learning more during CDI Week. And remember, we want your voice to be heard in this survey. Whether your experience aligns with the data I’ve shared today or not, your responses to this survey help us paint a more accurate picture of the CDI industry, which can then be used by CDI professionals everywhere to benchmark their own CDI practices.

If you respond to the survey by Friday, July 19, you’ll also have the opportunity to enter a fun ACDIS giveaway, so don’t miss out! Click here to respond now. We can’t wait to hear your experience and share the full report with our CDI community in September!

Editor’s note: Archibald is the associate editorial director, publications and membership, for ACDIS. Contact her at linnea.archibald@hcpro.com.