AHIMA and APPCA

Under the references comes the 3M Coding Reference Plus, and it contains AHA Coding Clinic for HCPCS, Coders’ Desk Reference for Procedures by Optum, Anesthesia Crosswalk, Faye Brown’s ICD-9-CM Coding Handbook, and ICD-10-CM and ICD-10-PCS Coding Handbook. The References include introductions, changes in the ICD coding, and guidelines for coders to find and better understand the coding process. For example, the Anesthesia section provides the section of the surgery and next to it the section where the right code can be assigned. Then, the Coding Clinic for HCPCS provide some articles and questions with their answers related to coding and the changes to some codes. These references are crucial in the coding sector, especially with the changes that occur on some codes and modifiers. Coders should be aware of the references and use them to avoid intention and non-intention mistakes, frauds or abuse.

The most important element in becoming a Medical Billing and Coding Specialist is the training and certification need to enter the field and for advancement. You will need a program that provides an understanding of anatomy, physiology and medical terminology. This program should also navigate the three topics: ICD, CPT and HCPCS. These codes help you document the conditions of a patient and describe the procedure performed on the patient. When you have completed your training there are several certifications you can test for. The American Health Information Management Association (AHIMA) offer certification for the Certified Coding Associate (CCA). You will need AHIMA membership and an exam fee ($199- $299), a high school diploma or

A philosophy of an organization helps differentiate themselves from their competitors and set a foundation for future success. It also helps shape an organization by presenting the goals they want to accomplish with specific activities. To improve this, many organizations understand the important of sharing values and goals and realize employee recognition. This helps staff from moving forward toward success of the organizations. Chapter 4 introduces “Codes of Ethics in Health Services.” Code of ethics is a guideline for healthcare professionals to accomplish and serve as a member of a society. Similar to other professions, managers have their own code of ethics in maintaining their duties and responsibilities. They also use the codes for ethical decision-making in dealing with ethical issues. Chapter 5 deals with “Organizational Responses to Ethical Issues.” It provides assistance for managers and organizations in their decision making. It is manager’s duty to figure out the problem and resolve it (Darr, 2011,

"Medical coding professionals provide a key step in the medical billing process. Every time a patient receives professional health care in a physician’s office, hospital outpatient facility or ambulatory surgical center (ASC), the provider must document the services provided. The medical coder will abstract the information from the documentation, assign the appropriate codes, and create a claim to be paid, whether by a commercial payer, the patient, or CMS." (Aapccom, 2015) It is very important that billing coders have a full understanding of how to properly use medical codes to prevent denial of claims submitted.

Utilize health information professionals and practice to ensure compliance with health data structures, standards and content.

AAPC was founded in 1988 implement education and professional certification to physician-based medical coders to elevate standards of medical coding by administering training, certification, networking and job opportunities.

The AAPC was founded in 1988 to provide education, training, certification, networking and job opportunities to physician-based medical coders.

As briefly mentioned above a code of ethics sets professional morals and ethical principles and offers ethical courses of action to which professionals seek. It also a way that can determine how their actions can be judged. Health information management (HIM) professionals are required to exhibit professional morals when it comes to their engagements with patients, employers, and members of the healthcare team, the public, and stakeholders they assist. A code of ethics is essential in aiding to monitor the decision-making process and can be referenced by people, agencies, organizations, and licensing and regulatory boards, insurance providers, courts of law, and other professional groups (AHIMA House of Delegates) .

Healthcare organizations have a moral and social responsibility to ensure that their communications are conducted using an outlined code of ethics. Whether the communication is an internal message to employees or mission outreach in the community, it must reflect the values and beliefs of the organization. Therefore, in order to establish and maintain the standard of ethical behavior and social responsibility, our organization requires all employees to complete new employee orientation sessions that define the policies and expectations. This orientation introduces our mission and values and it develops the foundation for our success as an organization. Our focus on encouraging and communicating ethical practices helps to reinforce our values to employees and the community. Furthermore, there should be a process in place that monitors and enforces the policies to safeguard against potential errors that would reflect poorly on the organization’s mission.

It encourages the HIM professionals to participate and promote their values, mission and principles in their areas of specialization in a professional and positive manner. If this information is given contrary to the expectations stated above, the public will hold the HIM professional accountable .AHIMA code of ethics requires every health information management professional to respect the dignity and worthy of each individual. This code of ethics is encouraged through respectful treatment of everyone, taking into consideration cultural and ethnic differences between every person, encourage self –determination for every person, valuing every kind and class of people in an equitable manner and ensuring all people are heard and respected. If one or all of the above expectation are not done or done in an opposite manner, some of these individual will create a negative image about the HIM professional or the

AHIMA recognizes that superior quality health care and clinical data are critical resources needed for effective healthcare, and works to assure that the health information used in care, research, and health management is valid, accurate, complete, trustworthy, and timely. This group is concerned about the effective management of health information from all sources and its application in all forms of healthcare and wellness preservation. Health issues, disease, and care quality also transcend across national borders. AHIMA’s professional interest is in the application of best health information management practices when and wherever they are needed. (The American Health Information Management Association, 2010).

The American College of Healthcare Executives (ACHE), has a strong impact on ethical decision making because they focus on the “entire being” of the healthcare professional. For example, in ACHE’s preamble of The Code of Ethics it states, “In fulfilling their commitments and obligations to patients or others served, healthcare executives function as moral advocates and models.” Imagine, when a healthcare administrator recites these few words, he cannot help but acknowledge the depth of his commitment and the high level of morality that is expected from him. Because of the vast number of complex ethical dilemmas that arise, ACHE further promotes the value and importance of strong ethical decision making in ACHE’s Ethics Toolkit. “When the ethical guidelines are not enough, when there is uncertainty about the proper ethical approach, and when there is a need to develop additional

Having an effective ethics and compliance in health care training course for employees within a company is a positive effort to keep not only the company running strong and efficient, but also developing standards for other companies to follow who are trying to create a more applicable format for corporate regulations. According to federal guidelines, designated and regulated by the Office of Inspector General (OIG), a company in compliance to federal healthcare standards will have effective education of employees, investigation measures, discipline and enforcement measures, intervention of violation standards, strong internal audit standards, compliance officers and staff, and lastly, written company standards and policies that is freely available to all employees.

Computer-assisted coding is defined as the “use of computer software that automatically generates a set of medical codes for review, validation, and use based upon clinical documentation provided by healthcare practitioners”

Ethical Codes are in use today by many organizations to clearly establish their values and provide a procedure if a code violation occurs. Medical ethics began as a professional code for physicians and has now expanded and includes a variety of health care professions and health care organizations. The growth of medical knowledge and technology have grown so have the concerns that ethical standards and issues facing our society today may be compromised or not appropriately addressed (Littleton et al., 2010).