A lot has changed in healthcare broadly and CDI specifically since the initial rollout of ICD-10-CM/PCS in 2015. From the advent of quality initiatives, to CDI’s expansion into other settings such as outpatient, to the evolution of clinical validation reviews, it seems that every day offers a new set of challenges and adventures. Much like the Wild West— the theme for this year’s CDI Week festivities—the world of CDI is expanding, and the individuals working in this world need to saddle up for the ride. Each year, ACDIS asks its members to weigh in on the state of the CDI profession in the CDI Week Industry Overview Survey.