Standards of Ethical Coding in Health Care Delivery Setting

This paper emphasizes the importance of maximizing the use of standards of ethical coding in health care delivery setting. The first point to emphasize is that ethical codes should promote professional values, principles and guidelines to which professional aspire to adhere to and to which their engagements can be judged from it. It should also help in guiding decision making processes and can be referred to by all the relevant stakeholders in health sector. Coding is one of the main functions under Health Information Management (HIM), and many coding professionals often encounter ethical challenges (Becker, 2011). That is why they need ethical codes when making any decision and implementing new policies in the sector. They are required to demonstrate performances that echo integrity, assurance to ethical and authorized coding practices and nurture trust in one’s professional accomplishments. Coding professionals are mandated to adhere to accuracy, completeness and consistency when establishing coding practices with the aim of producing high quality healthcare information. In addition to that, they are expected to safeguard the confidentiality of all health records without accessing protected data.

The Standards of Ethical Coding (SEC) need to be included in the organization’s policy and procedure manuals. This is because of the fact that policies and procedures are mainly established and used as frameworks for all work practices to be accomplished, and that relevant training is usually provided on their use by the human resource department to all employees upon employment. This means that chances of adherence to the provided ethical policies will be high with less non-compliance. The standards should be reviewed regularly to advocate for any policy and legislation changes with the aim of protecting customer confidentiality, compliance and other advocacy issues (Becker, 2011).This can be done on yearly basis to provide enough time for implementation and monitoring of new policies.

Adequate measures should be taken to discourage and prevent unethical conducts between coding professionals. It might be dismissal, censures, probation, and suspension of one’s membership or complete expulsion from the membership. The severity of the disciplinary action to be taken upon coding professionalsviolating the coding standards will depend on the violated standard and the frequency of violation. For example, an individual found to be guilty of changing reported codes with the aim of changing the meaning might face dismissal or expulsion from the organization and membership because it was dome with deliberate intentions (Ashcroft & Dawson, 2012). However, an individual who failed to advance ones coding knowledge so as to improve one’s effectiveness and efficiencies in the sector might be suspended for a few months and reinstated upon accomplishments of the education advancements.

Any imperfections in coding will definitely affect budget preparation process of health care organizations. This is because the organizations would have to take care of all costs accrued during the hearing and judgment of professionals sued for the misconducts if any ethical and legal issues arise. The organizations would be forced to allocate resources for risks adjustments in case such risks occur. It might also create conflicts between professional billers and coders and health care organizations. Since the billers and coders are responsible for coding all the diagnoses and processes provided by healthcare providers in the specified organization, any miscoding can lead to a number of ripple effects (Peden, 2011). It can delay billing and claim processes, and finally any compensation from insurance companies. This can lead to delays and lagging in healthcare delivery. It can also affect the quality of the services provided in the organization.

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