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AHIMA Code Of Ethics Case Study

488 Words2 Pages

This case happened in 2010 is about a retaliation for exposure of upcoding a bill at a small hospital in Nevada named Boulder City Hospital. The employer name Paula Sellers who worked in the Health Information Department as a procedural coder. Paula filed a lawsuit against her boss for firing her, and she doubts about the accuracy of the coding, and she refused to sign the procedure code under her name. According to the lawsuit Paula an alleged the hospital hired a company named Emcare. She audited four hundred twenty-eight claims and found three hundred fifty-three errors and she told her boss they would face criminal prosecutions for choosing higher-paying codes even if the services delivered did not justify them which is called upcoding …show more content…

Using your knowledge of the AHIMA Code of Ethics, what was the unethical part of the incident in the article and why? The unethical part of the incident in this article is that Paula boss should not alter or suppress the coded information because the patient trusted the hospital for the accuracy of billing. The patient does not know the fees or charges of the procedural and this will cause a fine or punishment to the facility (Pearson, 2018). 2. Identify the wrongdoing, and correct it using the points in the AHIMA Code of Ethics. The boss violated the Coding of Section 1 and the correction he should do is to support the solution of appropriate codes, develop and comply with internal coding policies, procedures and support honest and ethical coding practices (Pearson, 2018). Second Code he violated is Section 2. He should follow the ICD and CPT rules and guidelines. Comply with AHIMA standards governing reporting practices, documentation, and clinical query standards (Pearson, 2018). Third Code he violated is Section 11 he needs to be honest and represent credential, education, experience truthfully, accurately (Pearson, 2018). 3. Using this case as an example, why is AHIMA so important to ethics and industry

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