After reading the code of ethics you should be able to interpret the code of ethics and know how to use it. Due to the complex regulatory requirements affecting the coding process, coding professionals are frequently faced with ethical challenges.
Making the Most of External Coding Audits: Is your coding good, bad, or great? Not knowing for certain creates risk and stress. Audits offer visibility into departmental operations and coding processes. This is especially true in clinical coding.
In fact, coding audits have become so valuable that providers are advised to conduct external audits at least once a year. This outside review helps strengthen future internal audits by discovering how and why internal audits may have overlooked findings.
Getting a full return on an external audit requires that HIM directors commit to the process from start to finish—preparing, managing, and following up. AHIMA's advocacy and public policy team actively monitors, responds and participates in national policy and industry initiatives to shape and guide issues that are important to the health information management profession. Welcome to CodeWrite Welcome to CodeWrite, AHIMA's monthly e-newsletter created exclusively for coding professionals.. If there is an individual whom you feel would benefit by receiving this e-newsletter, please forward this to him or her to urbanagricultureinitiative.com for the next issue of CodeWrite in September.
HIM can make the most of them and achieve a clear return on investment by following through in three key steps: Preparing for the Audit The first step in preparing for an external coding audit is identifying clear, concise goals. These goals should be specific to the organization and designed to address current needs.
Once audit goals are clearly defined and documented, HIM directors can secure executive support, prepare coders, and identify cases. Setting goals will give HIM directors meaningful recommendations instead of binders full of unnecessary reports.
Some HIM directors will have a specific goal or organizational challenge that drives the audit. Others may have predefined areas for the audit based on internal quarterly review findings, staffing changes, or upcoming initiatives such as RAC. She was new to her position when she decided to contract with an outside agency to conduct a coding audit.
She had a clear goal—to obtain a solid baseline of coding quality. Phillips needed an auditing partner with pediatric coding experience and a thorough understanding of present on admission POA coding for pediatrics a topic that is not well-addressed in current POA guidelines.
Specialty consultants were able to bring a fresh perspective to POA reporting and increase consistency among the staff. For example, auditors and coders worked together to explore coding options for retinopathy of prematurity, a common condition in premature infants. ROP is screened for at birth; however, it does not arise until several weeks of age.
Should such conditions associated with extreme prematurity be considered POA or hospital-acquired? Located in rural Missouri, BRHC struggled for several years to recruit and retain experienced coders. McGraw finally decided to partner with a local community college to hire newly trained students as clinical coders within his organization.
Each BRHC coder is expected to obtain a 95 percent accuracy rate based on external auditor findings. If individual accuracy falls below this threshold, a corrective action plan is put in place.
For McGraw, external coding audits have become an important part of solving a local coder shortage. In addition, CFOs are advocates for any associated educational remedies or corrective actions that may result from an external audit.
Tips to Reduce Coder Anxiety Communicate goals early in the process Position the audit as an educational benefit Let results drive education for each coder Use findings as a tool for improvement Remind coders that no one is perfect Set individual performance goals, include in employee evaluation Establish an appeals process Prepare Coders HIM directors must work to ensure coders maintain a positive perspective throughout the audit.
Negative perceptions and fear can easily set in among the coding team when they imagine an external auditor pointing over their shoulders and scrutinizing their accuracy. Negativity leads to defensiveness, internal sabotage, and disregard for audit findings.
HIM directors can set the stage to help keep attitudes positive. Time spent early in the process can reduce the anxiety a coder might feel once the audit is complete and findings are presented.
Phillips recommends that external coding audits be positioned as an educational benefit for coders and a tool to boost their confidence. McGraw adds that audits have helped him target continuing education investments for each coder and set individual performance goals, which have become part of annual employee evaluations.
HIM directors can also emphasize team building and overall improvement, not specific coder deficiencies or punishment.
A few simple analogies may help coders remain positive, engaged, and part of the team. HIM directors can liken external auditors to personal trainers for coding improvement or compare them to physicians visiting each coder and providing prescriptions for professional health.
Finally, directors should establish a process for coders to dispute auditor recommendations and submit appeals. This will be the primary method for coders to appeal recommendations.
Identify Cases Using audit goals, internal audit results, or coder feedback can help determine the types of charts for review. Case mix index data alongside high-risk DRGs can also be used to direct audit activities and pinpoint areas for further investigation e.
Finally, the old adage to focus on problem-prone, high-risk, and high-volume areas is still good advice. Auditors should review visits that took place within the last full quarter so negative trends can be identified, errors corrected, and claims resubmitted if possible.CodeWrite (February ) You are trying to access a resource only available to AHIMA members.
Join today to have full access to everything in the BoK, take advantage of all the benefits of AHIMA membership, and become part of a network of more than , health information management professionals strong.
The “American Health Information Management Association or AHIMA” for short has several reasons for developing a Code of Ethics (American.., ). We will write a custom essay sample on AHIMA Professional Code of Ethics specifically for you.
for only $/page. We will write a custom essay sample on Critique of the AHIMA Code of Ethics specifically for you for only $ $/page. Order now It is the sole obligation of the HIM professionals to show actions that will mirror values and ethical principles.
This Code of Ethics has 6 principles. Getting a full return on an external audit requires that HIM directors commit to the process from start to finish—preparing, managing, and following up. The AHIMA Code of Ethics is intended to serve as a professional ethics guide for AHIMA members and credentialed professionals who are not members.
The code provides the ethical obligations of AHIMA members and credentialed non members as well as the 11 ethical principles that are the foundation of AHIMA’s Code of ethics.
Summarize the ethical issue and apply (reference) AHIMA Code of Ethics in your opinion of the resolution and or “how to have stopped” this issue from happening. Include the URL or web link for the ethical issue you are summarizing.