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Health Care Information Programs

CODE OF ETHICS 2004 of the
American Health Information Management Association

Ethical Principles: The following ethical principles are based on the core values of the American Health Information Management Association and apply to all health information management professionals.

Health information management professionals:

  1. Advocate, uphold and defend the individual's right to privacy and the doctrine of confidentiality in the use and disclosure of information.
  2. Put service and the health and welfare of persons before self-interest and conduct themselves in the practice of the profession so as to bring honor to themselves, their peers, and to the health information management profession.
  3. Preserve, protect, and secure personal health information in any form or medium and hold in the highest regard the contents of the records and other information of a confidential nature, taking into account the applicable statutes and regulations.
  4. Refuse to participate in or conceal unethical practices or procedures.
  5. Advance health information management knowledge and practice through continuing education, research, publications, and presentations.
  6. Recruit and mentor students, peers and colleagues to develop and strengthen professional workforce.
  7. Represent the profession accurately to the public.
  8. Perform honorably health information management association responsibilities, either appointed or elected, and preserve the confidentiality of any privileged information made known in any official capacity.
  9. State truthfully and accurately their credentials, professional education, and experiences.
  10. Facilitate interdisciplinary collaboration in situations supporting health information practice.
  11. Respect the inherent dignity and worth of every person.

STANDARDS OF ETHICAL CODING of the
American Health Information Management Association

In this era of payment based on diagnostic and procedural coding, the professional ethics of health information coding professionals continue to be challenged. A conscientious goal for coding and maintaining a quality database is accurate clinical and statistical data. The following standards of ethical coding, developed by AHIMA's Coding Policy and Strategy Committee and approved by AHIMA's Board of Directors, are offered to guide coding professionals in this process.

  • Coding professionals are expected to support the importance of accurate, complete, and consistent coding practices for the production of quality healthcare data. 

  • Coding professionals in all healthcare settings should adhere to the ICD-9-CM (International Classification of Diseases, 9th revision, Clinical Modification) coding conventions, official coding guidelines approved by the Cooperating Parties,* the CPT (Current Procedural Terminology) rules established by the American Medical Association, and any other official coding rules and guidelines established for use with mandated standard code sets. Selection and sequencing of diagnoses and procedures must meet the definitions of required data sets for applicable healthcare settings. 

  • Coding professionals should use their skills, their knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes. 

  • Coding professionals should only assign and report codes that are clearly and consistently supported by physician documentation in the health record. 

  • Coding professionals should consult physicians for clarification and additional documentation prior to code assignment when there is conflicting or ambiguous data in the health record. 

  • Coding professionals should not change codes or the narratives of codes on the billing abstract so that meanings are misrepresented. Diagnoses or procedures should not be inappropriately included or excluded because payment or insurance policy coverage requirements will be affected. When individual payer policies conflict with official coding rules and guidelines, these policies should be obtained in writing whenever possible. Reasonable efforts should be made to educate the payer on proper coding practices in order to influence a change in the payer's policy.

  • Coding professionals, as members of the healthcare team, should assist and educate physicians and other clinicians by advocating proper documentation practices, further specificity, and resequencing or inclusion of diagnoses or procedures when needed to more accurately reflect the acuity, severity, and the occurrence of events. 

  • Coding professionals should participate in the development of institutional coding policies and should ensure that coding policies complement, not conflict with, official coding rules and guidelines. 

  • Coding professionals should maintain and continually enhance their coding skills, as they have a professional responsibility to stay abreast of changes in codes, coding guidelines, and regulations.

  • Coding professionals should strive for optimal payment to which the facility is legally entitled, remembering that it is unethical and illegal to maximize payment by means that contradict regulatory guidelines.

Revised 12/99

* The Cooperating Parties are the American Health Information Management Association, American Hospital Association, Centers for Medicare and Medicaid, and National Center for Health Statistics. All rights reserved. Reprint and quote only with proper reference to AHIMA's authorship.