November 18, 2011
Coding is one of the core functions of healthcare providers and, due to the complex regulatory requirements impinging upon the health information coding process; the coding professionals are frequently faced with ethical challenges. There are stringent medical guidelines in place for the entire gamut of coding practices which include issues such as the privacy of patient healthcare data, accuracy, and regulation compliances.
This series of tutorials will help medical coders get comprehensive information about the standards of ethical medical coding norms and assist them in making ethically correct decisions in the workplace; these parameters can help evaluate the coding professionals’ commitment to integrity during the coding process.
Following are the set of guidelines recognized by AHIMA for ethical medical coding:
Coding professionals are liable to keep medical information private. As they are responsible for the transfer of information between doctors and insurance companies so integrity is of high importance in this profession. Coding related process includes completion of code assignment, coding audits and other healthcare data abstraction.
Coding professionals who handle medical information are generally required to sign confidentiality and non-disclosure agreements. To mitigate the risk of PHI handling, employers in the healthcare facilities have clauses in their contracts against intentionally or unintentionally data misuse which even subject them to prosecutions. If found guilty it can even lead to a fine up to $250,000 and/or imprisonment for up to 10 years, this not being the only reason for adherence to patient data security; Coders also comply with the following:
a. Patient’s information is only shared with health insurance companies. Patient’s medical history is not revealed to third parties
b. Confidentiality of the health records including personal, health, financial, genetic, and other information is protected with utmost care.
c. Ethical coders do not access protected health information which is not required for coding related process, it is with great trust that a patient shares this information with providers – it is vulnerability of the system which demands that other administrative staff has access to such crucial information.
The entire system of data handling is individually responsible for preservation of confidentiality of the PHI, especially certified and experienced Medical Coders.
Best Billing and Coding Practices