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CODE OF ETHICS of the
American Health Information Management Association
Preamble
This Code of Ethics sets
forth ethical principles for the health information management
profession. Members of this profession are responsible for maintaining
and promoting ethical practices. This Code of Ethics, adopted by the
American Health Information Management Association, shall be binding
on health information management professionals who are members of the
Association and all individuals who hold an AHIMA credential. Health
Information management professionals:
- Respect the rights and dignity of
all individuals.
- Comply with all laws, regulations,
and standards governing the practice of health information
management
- Strive for professional excellence
through self-assessment and continuing education.
- Truthfully and accurately
represent their professional credentials, education, and experience.
- Adhere to the vision, mission, and
values of the Association.
- Promote and protect the
confidentiality and security of health records and health
information.
- Strive to provide accurate and
timely information.
- Promote high standards for health
information management practice, education, and research.
- Act with integrity and avoid
conflicts of interest in the performance of their professional and
AHIMA responsibilities.
Revised & adopted by
AHIMA House of
Delegates
October 4, 1998.
STANDARDS OF ETHICAL
CODING of the
American Health Information Management Association
In this era of payment
based on diagnostic and procedural coding, the professional ethics of
health information coding professionals continue to be challenged. A
conscientious goal for coding and maintaining a quality database is
accurate clinical and statistical data. The following standards of
ethical coding, developed by AHIMA's Coding Policy and Strategy
Committee and approved by AHIMA's Board of Directors, are offered to
guide coding professionals in this process.
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- Coding
professionals are expected to support the importance of accurate,
complete, and consistent coding practices for the production of
quality healthcare data.
- Coding
professionals in all healthcare settings should adhere to the
ICD-9-CM (International Classification of Diseases, 9th revision,
Clinical Modification) coding conventions, official coding
guidelines approved by the Cooperating Parties,* the CPT (Current
Procedural Terminology) rules established by the American Medical
Association, and any other official coding rules and guidelines
established for use with mandated standard code sets. Selection
and sequencing of diagnoses and procedures must meet the
definitions of required data sets for applicable healthcare
settings.
- Coding
professionals should use their skills, their knowledge of
currently mandated coding and classification systems, and official
resources to select the appropriate diagnostic and procedural
codes.
- Coding
professionals should only assign and report codes that are clearly
and consistently supported by physician documentation in the
health record.
- Coding
professionals should consult physicians for clarification and
additional documentation prior to code assignment when there is
conflicting or ambiguous data in the health record.
- Coding
professionals should not change codes or the narratives of codes
on the billing abstract so that meanings are misrepresented.
Diagnoses or procedures should not be inappropriately included or
excluded because payment or insurance policy coverage requirements
will be affected. When individual payer policies conflict with
official coding rules and guidelines, these policies should be
obtained in writing whenever possible. Reasonable efforts should
be made to educate the payer on proper coding practices in order
to influence a change in the payer's policy.
- Coding
professionals, as members of the healthcare team, should assist
and educate physicians and other clinicians by advocating proper
documentation practices, further specificity, and resequencing or
inclusion of diagnoses or procedures when needed to more
accurately reflect the acuity, severity, and the occurrence of
events.
- Coding
professionals should participate in the development of
institutional coding policies and should ensure that coding
policies complement, not conflict with, official coding rules and
guidelines.
- Coding
professionals should maintain and continually enhance their coding
skills, as they have a professional responsibility to stay abreast
of changes in codes, coding guidelines, and regulations.
- Coding
professionals should strive for optimal payment to which the
facility is legally entitled, remembering that it is unethical and
illegal to maximize payment by means that contradict regulatory
guidelines.
Revised 12/99
* The Cooperating
Parties are the American Health Information Management Association,
American Hospital Association, Health Care Financing Administration,
and National Center for Health Statistics. All rights reserved.
Reprint and quote only with proper reference to AHIMA's authorship. |
© Copyright 2004,
2005 Health Information Technology, Danville Area
Community College
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