The Eleven Principles
ELEVEN PRINCIPLES FORM the foundation of AHIMA’s code
of ethics. They serve as a guide to members and anyone who
holds the association’s credentials:
I. Advocate, uphold and defend the individual’s right to
privacy and the doctrine of con;dentiality in the use
and disclosure of information.
II. 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
III. 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 con;dential nature, taking into account the
applicable statutes and regulations.
IV. Refuse to participate in or conceal unethical practices
V. Advance health information management knowledge
and practice through continuing education, research,
publications, and presentations.
VI. Recruit and mentor students, peers and colleagues to
develop and strengthen professional workforce.
VII. Represent the profession accurately to the public.
VIII. Perform honorably health information management
association responsibilities, either appointed or elected, and preserve the con;dentiality of any privileged
information made known in any of;cial capacity.
IX. State truthfully and accurately their credentials, professional education, and experiences.
X. Facilitate interdisciplinary collaboration in situations
supporting health information practice.
XI. Respect the inherent dignity and worth of every person.
The full code of ethics is available at www.ahima.org/about/
ethicscode.aspx. It features a preamble that describes the
ethical obligations of AHIMA members and credentialed nonmembers and explains the code’s six purposes. It also describes how to use the code and provides guidelines to assist
members in interpreting its principles. A self-assessment and
further case studies are available.
AHIMA also maintains standards of ethical coding and ethical standards for clinical documentation improvement professionals, both available online at the above address.
Discuss It Online
Discuss these scenarios online on the Journal Web site. What
leads to situations like these? How “wrong” is each behavior?
What steps can be taken to resolve and prevent these scenarios and others like them?
;e choice the coder makes may depend on the corporate
culture. Does the culture encourage the reporting of violations?
Will the company protect the coder if she informs another supervisor about the situation?
“I’d suggest she seek advice from a trusted HIM professional,
just to be sure the direction given is indeed inappropriate,” says
Mc Way. “If so, she needs to learn what process is available for
voicing her concern to a higher level. Some organizations have
an ombudsman or similarly situated individual who can help in
situations like this.”
“She has a decision to make. If she
chooses to include the incomplete
records in the ;nal;report, she has
—Donna L. Kraybill
Scenario 2: Underreporting Delinquent Records
An HIM graduate with two years experience is employed by a
large academic healthcare center and placed in a management
position over the analysis and chart completion area. Using
reports generated by the IT department to calculate the chart
delinquency rate, she determines there are incomplete charts
more than 30 days old. ;e charts are in a pending ;le and have
not been counted in the total number of delinquent records.
If these records are counted, the delinquency rate will be
above the required standard by the Joint Commission. Will she
intentionally misrepresent the delinquency rate and not count
the reports, or will she take appropriate action to remedy the
“She has a decision to make,” says Donna L. Kraybill, MS,
RHIA, associate professor at Tulsa Community College in Okla-
homa. “If she chooses to include the incomplete records in the
;nal;report, she has acted ethically.;I would also recommend
that she notify her superior.;If her superior asks her not to in-
clude the incomplete records, that creates a whole new scenar-
io—but she should still refuse to act unethically.”
As an HIM graduate, the manager should be aware of the cor-
rect method to calculate incomplete records. However, if she is
not a member of AHIMA or is not credentialed, she may not be
aware of the code of ethics. Regardless of intent, if she acts un-
ethically there is potential harm to the organization (and possi-
bly AHIMA, if she is a credentialed member). ;e organization’s
reputation would be jeopardized if the organization knowingly
engaged in this practice.
“If the violation is intentional, the organization should self-report the incident to accrediting agencies, even though loss of
accreditation could occur,” says Kraybill.
As in the ;rst scenario, this scenario involves principles II and
IV. Guidelines that may be compromised include 2. 1 (integrity),
2. 2 (true to mission), 2. 4 (compliance with the code of ethics),
and 4. 6 (not participating in or supporting dishonesty, fraud
and abuse, or deception). Hiding incomplete records is an ex-