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You are a new coder at FYI Hospital. As part of your orientation you read Coding Integrity policies and feel as though you are working for an ethical organization. After your first month, you see conflicting documentation regarding a diagnosis in the patient record. You ask your coding supervisor how you should handle it. Maybe a query to the physician would be helpful. Your coding supervisor instructs you to pick the diagnosis that brings the hospital the most reimbursement saying the A/R backlogs are too serious to take time out to query the physician.
You remember the AHIMA Code of Ethics that address this issue:
Refuse to participate in or support coding or documentation practices intended to inappropriately increase payment, qualify for insurance policy coverage, or skew data by means that do not comply with federal and state statutes, regulations and official rules and guidelines.
Answer the following questions:
1. What consequences could result from following the instructions of the coding supervisor?
2. Who would it hurt and who might benefit (if anyone)?
3. How would you respond to the supervisor's instructions?
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