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 CDI in Orbit: Infinite Opportunities, highlighting the endless opportunities in the CDI profession to reach for the stars when it comes to focus areas, collaboration, and career paths.

Each year leading up to CDI Week, ACDIS conducts a survey to gain insight into the state of the industry. This year’s survey included questions about provider engagement, CDI query metrics and technology, risk adjustment, denial trends and CDI involvement, and nontraditional settings. It marks the 14th annual CDI Week Industry Survey, continuing more than a decade of industry evaluation.

“The annual CDI Week Industry Survey allows us to collectively get a pulse on what’s happening now and what’s to come in our wonderful world of CDI,” says Tiara Minor, RN, BSN, CCDS, director of CDI at the University of Miami Health System in Florida. “Each of us functions independently at our organizations, so it’s extremely valuable for ACDIS to provide a platform that allows anyone with a connection into the CDI industry to […] contribute honest feedback that allows us to gain collective insights. CDI has been rapidly evolving since its inception, so the survey also gives us a reminder about how far we’ve come when you look at the survey data [and] compare with prior years.”

This year, 822 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 first asked their title and role to understand the field’s current demographics and scope of positions. Echoing previous years, the role of CDI specialist was chosen by the largest number of respondents (35.87%), followed by CDI managers (19.87%), directors (14.71%), and leads (4.65%), with CDI educators following close behind (4.26%). In the last few years, the percentage of respondents working in an acute care hospital has seen a consistent decrease, and 2024 continues this trend: 36.13% selected this organization type, in comparison with 40.06% in 2023. This year-over-year trend may indicate an increase in CDI positions available at other types of organizations and the continued broader healthcare trend of stand-alone hospitals consolidating into healthcare systems. (See Figures 1 and 2.)

“Something that stands out to me are the job titles, which represent the ever-changing landscape in CDI with diversified career pathways beyond traditional CDI reviewers,” says Minor. “This year there were more CDI second-level reviewers, educators/auditors, CDI-coding liaisons, and CDI denials specialist responses compared to last year. I foresee in the coming years we’ll see more roles added and higher volumes in specialized roles, such as CDI-UR [utilization review] specialists, inpatient versus outpatient CDI specialists, and possibly further distinguishment in second-level reviewer titles, such as ones focused on risk adjustment or mortality.”

When asked about time in their current role, 58.20% of respondents said between zero and five years, and another 26.97% said between six and 10 years. When asked about their time in the profession overall, a slightly higher number (7.48%) of respondents said they’ve been in the CDI profession for up to two years compared to 2023 (6.62%). Regarding how long they intend to stay in CDI, an increased number of respondents said they intend to stay for more than 20 years (22.45% in 2024 compared to 18.77% in 2023). Another 15.35% answered that they were unsure, followed closely by 14.58% who plan on staying for the next 11–15 years. (See Figure 3.)

The number of facility beds reported by respondents saw little change in the past year, with 24.90% of respondents reporting their facility has between 101 and 400 beds, 37.03% reporting between 401 and 1,000 beds, and 18.71% reporting more than 1,000 beds. (See Figure 4.)

As far as total number of beds in their health system, those with 500 or fewer beds saw a small increase from 8.68%% in 2023 to 21.67% in 2024, while the number of those who answered they were not part of a healthcare system saw another small decrease year-over-year from 13.41% in 2023 to 12% in 2024. (See Figure 5.)

The CDI industry continues to attract professionals from various backgrounds, as evident in the extensive assortment of credentials selected by respondents this year. Most respondents (70.45%) noted that they hold an RN credential, though this was a decrease from 2023 (74.13%), possibly due to a wider variety of respondents from other backgrounds. In contrast, the number of respondents who hold ACDIS’ Certified Clinical Documentation Specialist (CCDS) credential saw another increase (70.32% in 2024 compared to 66.09% in 2023), indicating it may be becoming more of a standard credential for CDI professionals. All other credential options offered on the survey showed a return to 2022 response rates, indicating the changes in 2023 may have been a temporary phenomenon. (See Figure 6.)

“As with prior years, the CCDS and RN certifications by far represented the highest percentages of credentialed respondents,” says Minor. “I agree this accurately represents the majority of professional demographics in CDI, but also recognize that many CDI professionals have earned other credentials, including coding certifications, healthcare providers (NP, MD, PA, etc.,), and other advanced degrees (master’s and doctorate).”

When asked about reporting structure, 34.58% of respondents said their CDI department reports to revenue integrity/cycle, followed by 18.45% who report to HIM/coding, 14.32% who report to finance, and 13.55% who report to quality. A little over 7% of respondents indicated they have a stand-alone CDI department. (See Figure 7.)