ACDIS celebrates CDI professionals annually with a full week of recognition for the profession through activities, education, and fun. This year’s CDI Week theme is Under the Sea-DI, celebrating the often underappreciated and unseen efforts CDI professionals contribute to benefit their organizations.

Each year leading up to CDI Week, ACDIS releases a survey to gain insight into the state of the industry. This year’s survey included questions about the productivity, staff engagement in the remote environment, provider engagement, outpatient CDI and risk adjustment, and denial trends and CDI involvement. It marks the 12th annual CDI Week Industry Survey, continuing more than a decade of industry evaluation.

“The CDI profession continues to evolve and the surveys that ACDIS compiles aide us in knowing not only where pain points may be for other programs but also those areas of success as well,” says Lena Wilson, MHI, RHIA, CCS, CCDS, RCS specialized manager of CDI and ICD-10 clinical education at Indiana University Health in Indianapolis.

This year, 711 respondents took part in the survey. Although this report will not discuss every survey question in detail, readers can examine all the responses in table format beginning on p. 12.

Survey respondents were asked their title and role to get a picture of different positions within the field. Similar to last year’s results, CDI specialists made up the largest group, with 43.32% of respondents fitting into this role. This number, however, is down slightly from last year’s 44.39%. The change is likely due to more 2022 respondents who are CDI managers (18.28% versus 17.37% in 2021) and directors (12.66% versus 11.44% in 2021). The shift from respondents in CDI specialist roles to those in higher positions likely demonstrates individuals growing within their careers. (See Figure 1.)

In comparison to 2021, the percentage of respondents working in an acute care hospital (45.29%) decreased slightly (from 48.09%). (See Figure 2.)

Only 13.64% in 2022 said that they have been in their current profession for over 20 years, down drastically from 33.47% in 2021, which could be due to the influx of new CDI professionals into the profession evidenced in the 2021 CDI Salary Survey. Additionally, 20.68% have been in the profession for six to eight years, and 19.97% selected 11 to 15 years. Most respondents (60.62%) have been in their current role between zero and five years, an increase from 2021 (56.36%). An additional 16.74% have been in their role for six to eight years, and 1.69% of respondents have been in their current role for more than 20 years. (See Figure 3.)

When respondents were asked how long they intend to stay in CDI, their answers were spread fairly across the board. Most respondents said they intend to stay for more than 20 years (19.13%), and an additional 10.55% said they intend to stay for three to five years, while 12.80% of respondents picked the middle road and answered nine to 10 years. (See Figure 3.)

“It is great to see that there is a distribution of those of us in the CDI profession—those who are early on in their career with zero to 10 years in the profession but also those that are more tenured in their careers with 11+ years in the field,” says Wilson. “As a leader and knowing that the bulk of respondents are CDI specialists, it is great to see that there are about 42% of the respondents that are looking to stay in the CDI profession for 11+ more years.”

Most respondents (30.66%) indicated their facility has between 101 and 400 beds, and 28.27% said the total number of beds in their health system is 3,000 or more. (See Figures 4 and 5.) These numbers are comparable to those on the 2021 CDI Week Industry Survey (34.22%, 25.53%), as well as those with more than 2,000 beds in their healthcare system (from 37.29% in 2021 to 38.82% in 2022), and those who answered they were not part of a healthcare system (from 14.62% in 2021 to 14.77% in 2022). These findings remain consistent with last year’s results.

Folks in the CDI field come from different educational and professional backgrounds, including nursing, coding, and health information management (HIM). Because of this, it is not uncommon for CDI professionals to hold a vast array of credentials. Most respondents (72.01%) noted that they hold an RN credential, and 61.88% of respondents hold ACDIS’ Certified Clinical Documentation Specialist (CCDS) credential. All other credential options offered on the survey had lower response rates. For example, 16.88% of respondents noted holding the CCS, 9.28% hold the CDIP, and 5.63% hold an RHIA credential. (See Figure 6.)

“Given my background in HIM/coding, I personally would like to see more representation by coding professionals,” Wilson says. “I believe that a CDI team comprised of RNs and those with a HIM/coding background will foster a more collaborative relationship amongst the entire CDI team. So much of what we do is combining the skillsets of our individual backgrounds/degrees and the knowledge shared only continues to strengthen the overall knowledge of the team.”

About 30% of respondents said their CDI department reports to revenue integrity/cycle, and next in popularity, 21.38% of respondents report to HIM/coding. Finance garnered 13.08% of responses, quality got 12.10%, and 7.88% of respondents indicated they have a standalone CDI department. (See Figure 7.)