The AHIMA Code of Ethics
The AHIMA Code of Ethics establishes core values guiding professional conduct for health information management practitioners, including respect for patient privacy, honesty and integrity in professional dealings, and a commitment to advancing the profession. RHIA candidates should understand the code as both an aspirational framework and a practical guide for resolving day-to-day ethical dilemmas.
Core Ethical Principles
- Advocate for the protection of confidential health information at all times
- Refuse to participate in fraudulent coding or billing practices, even under pressure from supervisors or physicians
- Maintain professional competence through ongoing education and skill development
- Report unethical or illegal conduct through appropriate organizational or regulatory channels
- Treat colleagues, patients, and the public with honesty, fairness, and respect
Common Ethical Dilemmas
HIM professionals may face pressure to assign a higher-weighted code than documentation supports in order to increase reimbursement, requests from administrators to release information without proper authorization to expedite a business need, or requests from family members to access a deceased or incapacitated patient's records without proper legal authority. Each scenario requires balancing competing pressures against the professional's ethical and legal obligations.
Whistleblower Protections and Reporting Obligations
When a coding professional identifies a pattern of systematic upcoding or fraudulent billing, ethical obligation and often legal requirement compel reporting through internal compliance channels or, if internal channels fail to act, external regulatory bodies. Federal whistleblower protections exist to shield employees who report fraud in good faith from retaliation.
Ethical Decision-Making Frameworks
When facing an ambiguous ethical situation, HIM professionals can apply a structured decision-making process: identify the ethical issue, gather relevant facts, identify the stakeholders affected, consider applicable laws and professional standards, evaluate alternative courses of action, and select the option that best upholds professional integrity while minimizing harm.
Consequences of Ethical Violations
Violations of the AHIMA Code of Ethics can result in disciplinary action against professional credentials, in addition to potential legal liability under fraud and abuse statutes when the conduct also violates applicable law.
Exam Tip
Expect scenario-based ethics questions asking you to identify the most appropriate course of action when facing pressure to compromise coding accuracy or patient privacy protections.