Legal and Ethical Aspects of Medical Billing and Coding

Getting into the legal and ethical considerations that underpin the medical billing and coding profession. You’ll learn about patient privacy (HIPAA), fraud prevention, and compliance with coding standards. We’ll also discuss the importance of maintaining the highest ethical standards in your role. Understanding these aspects is essential to ensure the integrity and security of healthcare information.

Maintaining Confidentiality

Among the most important of medical coding ethics standards is confidentiality. Failure to maintain confidentiality is breaking the law. With access to the most intimate details of patient records, you must maintain absolute confidentiality when coding procedures for insurance companies. Included in your confidentiality responsibilities is the assurance that you won’t access health information not related to the procedure you’re working on. In addition to the ethical standards you must maintain as a medical coder, confidentiality is legally required by the Health Insurance Portability and Accountability Act, or HIPAA, which protects patient information.

Ensuring Accuracy

The ethical standards of both the American Health Information Management Association and the American Association of Professional Coders require absolute accuracy in your duties. Part of your oath as a medical coder requires you to follow the rules and never enter a code that does not accurately reflect the actual work performed by the provider. Ethics must drive your practices; you could be found guilty of fraud if you participate in inaccurate billing practices.