New ACDIS/AHIMA physician query practice brief (2026) puts mid-revenue cycle leaders front and center in compliance

By Brian Murphy

At the ACDIS conference last week, a bombshell announcement: A new physician query brief, the joint output of ACDIS/AHIMA.

You can read it here on the ACDIS website. The organizations are accepting comments through June 12, and may make changes based upon them. So, give it a thoughtful read and submit your own.

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The brief is 36 pages (does that mean it’s not brief?), far more than I can summarize here. But here’s a few thoughts.

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• It reinforces that the goal of a query is clinical precision.
• Auditors should not use it to deny claims. It’s a reminder that the brief is a guideline, not a regulation. Does that mean it can be skirted?
• It applies to any setting, inpatient or outpatient.
• Yes/no queries are permitted for verifying a dx that already exists elsewhere in provider documentation. The option of “unable to determine” is required in POA and all yes/no queries.
• MEAT is not used as a basis for code support, but is implicit in this statement: “Information from prior encounters may be used to support a query when it is clinically relevant to the current encounter. However, prior encounter documentation cannot serve as the sole basis for a query, and sufficient supporting information must be present within the current encounter.”
• It permits coding from a query response alone, as long as the query form is retained as part of the permanent medical record. If not, the provider must document his/her response in the medical record. One response seems enough. “The response to the query is not required to be repeated elsewhere in the health record.”

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Above all this:

It’s a call to action, action which may be difficult for you, HIM or CDI Director. Because it reinforces that EVERYONE engaged in the query process must follow it.

So…

If you have outsourced your CDI function, are your contractors following the query guidelines?

What if they are managed by another company? Or, are overseas?

Are you prepared to have uncomfortable conversations, up and down the chain of your organization? Including with your high-priced consulting firm who promised outsized ROI, or your even higher priced tech platform (and the C-suite execs who authorized its purchase)?

This is what the brief is calling us to do.

The guidelines are not a pat answer to point to and say, “follow this.” It’s a call to action, to say “follow me, and ACDIS/AHIMA.”

The brief says:

“This practice brief should be shared and discussed with all healthcare professionals whose work intersects with health record documentation, including quality, compliance, revenue cycle, patient financial services, physician groups, facility leaders, care management, informatics, and information technology (IT).”

You are that sharer.

Should ACDIS/AHIMA be presenting this brief to the likes of Epic? I think so. It will be interesting if that organization offers a comment.

Which is the last important takeaway.

If you disagree with the brief, or love it, leave a comment.