Standards of Ethical Medical coding: Part 1

Coding is one of the core functions of healthcare providers and, due to the complex regulatory requirements impinging upon the health information coding process, coding professionals are frequently faced with ethical challenges. There are stringent medical Billing 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 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:

Accuracy and Consistency:

Coding professionals and managers shall apply accurate, complete, and consistent coding practices for the production of quality healthcare data. They should

  • Support selection of appropriate diagnostic procedure and other types of health service-related codes such as type of disease, admission indicator, and discharge status
  • Develop and comply with comprehensive internal coding policies and procedures that are consistent with official coding & regulation guidelines,
  • prohibit coding practices that misrepresent the patient’s medical conditions and treatment provided or are not supported by the health record documentation
  • Promote an environment that supports honest and ethical coding practices resulting in accurate and reliable data, irrespective of the purpose for which codes are being reported
  • Refrain from alteration, or suppression of coded information