A high volume of unanswered queries most directly indicates inadequate provider engagement. This question is adapted from the current ACDIS Candidate Handbook's publicly released CCDS sample questions.
A provider may legitimately agree or disagree with a CDI query. Disagreement does not necessarily indicate poor engagement because the purpose of a query is clarification, not obtaining a predetermined diagnosis. A physician who reviews the clinical information and documents that the condition is ruled out, clinically undetermined, or otherwise different from the proposed possibilities is still participating appropriately.
Likewise, the number of queries generated is primarily a CDI workload or opportunity metric. It does not demonstrate whether physicians are responding.
A persistent nonresponse rate is more concerning because unanswered queries can delay final coding, create unresolved ambiguity, affect billing timeliness, reduce documentation completeness, and indicate weaknesses in provider communication or organizational query escalation procedures.
A CDI manager should not evaluate engagement from a single metric in isolation. Response time, response rate, education participation, documentation trends, service-line differences, and escalation frequency provide additional useful context.
CCDS Reference Topics: Physician engagement; query-response metrics; CDI analytics; program effectiveness.
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