Assessment of Ethical Standards in Health Care

Assignment Resources

AHIMA Standards of Ethical Coding

Crawford, Mark, “Everyday Ethics: AHIMA Code of Ethics Guides Daily Work, Complex Situations” Journal of AHIMA 82 no. 4 (April 2011): 30-33

Assignment Objectives

• The learner will evaluate the behavior of Health Information Management personnel using ethical coding standards

Assignment Instructions

• Access, read, and carefully review assignment resources
• Access, read, and carefully review the modular resources
• Evaluate the case scenario closely
• Demonstrate the ability to judge behavior (ethical or unethical) of coding by completing Ethical Decision -Making Process Tool based on the facts presented in the case scenario
• Evaluate the behavior (ethical or unethical) of a coding manager by listing the AHIMA Ethical Coding Standards that would be violated based on the case scenario. Students are mandated to submit their rationale for each selected standard.

Case Scenario    

You are a newly hired medical coding specialist working for a large regional physician group practice. Shortly after being hired, you are informed that the practice is behind on filing claims.  It has been determined that the delay in filling claims is due to delinquent physician documentation. You inform the practice that reimbursements are in jeopardy due to timely filling standards. The coding manager verbally instructs you to take the following actions in relation to the problem:

• She instructs you not to wait until the physician completes his or her documentation if the encounter occurred more than 15 business days prior to the calendar date
• She instructs you to use the condition on the billing sheet or triage sheet to abstract your first listed diagnosis code if physician has not documented the first listed diagnosis yet
• She instructs you to cut and paste from prior EHR notes making it easier for the physician to complete his or her documentation
• She instructs you to blindly code for the mid-level outpatient Evaluation and Management CPT code if the document is incomplete or missing.

Required Tasks                                                                                                                                                                   1.0                                                                                                                                                                               Based on the facts presented in the case scenario fill in the Ethical Decision-Making Process Tool using the Subdomain VI.7 Answer Sheet. The student will be required to demonstrate the ability ASSES ethical standards of practice.

Task 2.0                                                                                                                                                                         Based on the facts presented in the case scenario fill in the AHIMA Standards for Ethical Coding Rationale Tool using the Subdomain.VI.7 Answer Sheet. The student will be required to demonstrate the ability to EVALUATE ethical standards of practice.