Revenue Cycle Insider

Question: Which is the “safest” type of written query format: open-ended, multiple choice, or yes/no?

Delaware Subscriber

Answer: When formulated in a particular way, multiple-choice queries can be the gold standard, said Marianne Durling, MHA, RHIA, CPC, CCS, CDIP, CPCO, CDEI, CIC, during her presentation “Queries Gone Bad” at AAPC’s DOCUCON 2025.

Regarding documentation, specialists are often told to be wary of templates, but templates are actually useful and important for queries. “We want them to be standardized as much as possible, because then there’s no leading queries; there’s nothing that can come back and say, ‘Well, you kind of threw out diagnoses and encouraged the physician to choose a higher [diagnosis-related group] DRG level in your query.’ We want to remove any of that potential: We want them all to be aboveboard. We want them to all be clear and transparent,” she said.

Open-ended queries can be compliant, as it’s hard to “lead” a provider when they answer entirely of their own accord; but a coder or documentation specialist may not get the information needed to support a code selection or for the patient’s record, she said.

A multiple-choice query composed of open, clear options supported by clinical indicators, none of which are favored over another, is sort of the gold standard for queries because the physician can easily choose an option and you thus have a higher chance of getting the information you need, Durling said. There aren’t any mandatory or minimum number of choices for a compliant query, but the querier should always include an “undecided” option so the provider can fill in the information themselves.

Yes/no queries are also useful, but only if and when the clarification you’re seeking can actually be answered via yes or no, she said. 

Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC