Regulatory Committee Insight: Building defensible query practices under regulatory pressure

The regulatory environment surrounding CDI has never been more demanding, and therefore, compliant query practices have never mattered more. Recovery audit contractors, commercial payers, and government reviewers are scrutinizing documentation and claims with unprecedented precision. Against that backdrop, one principle must anchor every CDI program: a defensible query practice is a formally governed, clinically grounded process in which every query is supported by objective clinical indicators, free of leading language, and consistently documented. 

The ACDIS Regulatory Committee thanks Lizabeth A. Volansky, MSN, RN, CCDS, RHIA, CDIP, CCS, for serving as lead author for this work.