Access and review the AHIMA standards of ethical coding. Using the attached rubric develop a well-thought-out original response by identifying two of the ethical coding standards and provide one ethical issue that might occur if one of the two standards you selected is not adhered to in a healthcare facility. Be sure to be specific and provide examples. using a minimum of one reference to support your point of view.
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Introduction:
As a medical professor responsible for creating college assignments for medical college students, it is crucial to ensure that the content addresses ethical considerations in the field of medical coding. This assignment prompt requires students to review the AHIMA standards of ethical coding, select two standards, and discuss one potential ethical issue that may arise if one of the chosen standards is not followed within a healthcare facility. A well-thought-out response will demonstrate an understanding of ethical coding practices and provide specific examples to support the argument.
Answer:
One of the ethical coding standards outlined by AHIMA is standard 1.1, which states, “Code all relevant diagnoses and procedures.” This standard emphasizes the importance of accurately coding all pertinent diagnoses and procedures to ensure comprehensive and accurate patient records. Failure to adhere to this standard can lead to various ethical issues in a healthcare facility.
One potential ethical issue that may arise if this standard is not followed is the underreporting of diagnoses and procedures. If a healthcare facility does not code all relevant diagnoses and procedures, the patient’s medical record may lack crucial information, leading to incomplete documentation and potentially compromising the quality of care provided. For example, if a patient undergoes a surgical procedure but it is not properly coded, subsequent healthcare providers may not be aware of the surgical intervention, resulting in incorrect treatment decisions or ineffective follow-up care.
Furthermore, underreporting diagnoses and procedures can have financial implications for both the healthcare facility and the patient. The accurate coding of diagnoses and procedures is essential for reimbursement purposes, as it ensures that healthcare providers are appropriately compensated for the services provided. If relevant procedures or diagnoses are not coded, the healthcare facility may face financial losses. Additionally, undercoding can impact the patient’s insurance coverage, as it may result in denials or limited reimbursement for necessary medical services.
To support this viewpoint, the American Health Information Management Association’s (AHIMA) Standards of Ethical Coding state that “the coding process requires discretion, as well as the ability to evaluate and make decisions based on ethical coding principles.” (AHIMA, 2021). This reference emphasizes the importance of adherence to ethical coding standards and further supports the argument that the underreporting of diagnoses and procedures can lead to ethical issues within a healthcare facility.
In conclusion, it is crucial for healthcare facilities to follow ethical coding standards such as standard 1.1 outlined by AHIMA. Failure to adhere to this particular standard may lead to underreporting of diagnoses and procedures, resulting in incomplete medical records, compromised patient care, financial implications, and potential insurance coverage issues. Upholding ethical coding practices ensures comprehensive and accurate patient documentation, ultimately contributing to high-quality healthcare delivery.
