CDI education focused on diagnosis specificity and complete, clinically supported documentation most directly influences theQualityandCostperformance categories. In the Quality category, many measures depend on correct identification of eligible patient populations (denominators), exclusions, and risk adjustment. When providers document conditions precisely (e.g., specific heart failure type, diabetes complications, CKD stage), it improves the accuracy of coded data that underpins measure calculations and risk stratification. In the Cost category, CMS uses claims-based methodologies that compare observed versus expected costs; accurate diagnosis capture affects patient complexity and risk adjustment, which can materially change expected cost targets and episode attribution. ACDIS outpatient CDI principles emphasize that incomplete or vague documentation can make patients appear less complex than they are, potentially worsening both quality comparisons and cost benchmarks. By contrast, Promoting Interoperability is driven primarily by EHR use and electronic processes, and Improvement Activities reflect practice transformation/engagement rather than diagnosis specificity. Therefore, Quality and Cost are the MIPS categories most impacted by CDI education on specificity.
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