While CDI may have gotten its start in the inpatient environment, outpatient providers have recognized the benefit and started programs, as well. The nature of inpatient and outpatient CDI programs vary, but they share a goal of increasing the accuracy of clinical documentation and coding. Outpatient clinical documentation improvement or integrity (CDI) involves the review of outpatient medical records in the ambulatory, emergency department, same-day, observation, or clinic setting to capture and support complete documentation by physicians of diagnoses especially those included in CMS’ hierarchical condition categories (HCCs) having an impact on physician reimbursement and quality scores. Outpatient CDI may also focus on physician office visit documentation for assignment of professional evaluation and management (E/M) coding upon which physician compensation largely depends.