C801 Task 2 HIM Ethics Presentation Example

When the Right Answer Costs Something: Four Ethical Situations in Health Information Work, Read Against the AHIMA Code of Ethics

Student Name

Leavitt School of Health, Western Governors University

C801: Health Information Law and Regulations, Task 2

Course Instructor

Month Day, Year

Slide 1: Why This Matters

Health information staff see more of the record than almost anyone

Most ethical problems arrive as ordinary requests

Today: the code, four situations, and what to do on Monday

Speaker notes: Good morning. Health information management staff handle more of the record than almost anyone in the hospital: coders read every note, release of information staff see every request, and analysts build the reports leaders rely on. That access is a trust, and it is tested most often by requests that look routine. In the next twenty minutes I will introduce the AHIMA Code of Ethics, work through four situations our department could face this month, and finish with the supports available when you are unsure what to do.

Slide 2: The AHIMA Code of Ethics

Thirteen principles, revised 2019

Applies to every AHIMA member and credential holder

Values: privacy, service, integrity, honesty, respect

Speaker notes: The AHIMA Code of Ethics sets out thirteen principles for health information professionals, most recently revised in 2019 (American Health Information Management Association [AHIMA], 2019). It applies to members and credential holders, but its principles describe good practice for anyone who works with health information. The code rests on values we all recognize: protecting privacy, putting service before self-interest, acting with integrity and honesty, and respecting the dignity of every person. The code does not tell you what to do in every case. It gives you the questions to ask.

Slide 3: Ethics and Law Are Not the Same

Law: what we must do

Ethics: what we should do, including where law is silent

An action can be legal and still wrong

Speaker notes: Before the situations, one distinction. The law sets a minimum. HIPAA tells us what we may and may not disclose, and the False Claims Act tells us what happens when a claim is false. Ethics asks more. It covers situations the law does not address, and it asks us to act well even when no one would find out. Several of today's situations involve both, and the code's fourth principle, to refuse to participate in or conceal unethical practices and to report them, is often the link between the two.

Slide 4: Situation 1, Pressure to Code for Payment

A manager asks coders to add a complication whenever a note mentions low sodium

Revenue is down; the request is framed as capturing documentation

Principles: 4 (refuse unethical practices), 5 (use data as intended)

Speaker notes: In the first situation, a finance manager emails the coding team. Revenue is down, and the manager asks coders to report hyponatremia as a secondary diagnosis whenever a sodium value is low, because it can raise the case's payment. The request is presented as capturing documentation fully. The problem is that a secondary diagnosis may only be reported when the provider documents it and it meets the reporting criteria in the official guidelines, such as requiring treatment, evaluation or monitoring (National Center for Health Statistics, 2025). A lab value alone is not a diagnosis. AHIMA's Standards of Ethical Coding direct coders to apply official guidelines and to refuse to change codes or documentation in order to increase payment (AHIMA, 2016).

Slide 5: Situation 1, What To Do

Code from provider documentation, never from lab values alone

Where documentation is unclear, send a compliant, nonleading query

Decline the instruction in writing and involve the coding manager

Speaker notes: The right response has three parts. Keep coding from provider documentation and the official guidelines. If a low sodium value appears to have been treated but no diagnosis is documented, send the provider a compliant query that presents the clinical facts and does not suggest an answer or mention payment. And reply to the instruction, respectfully and in writing, explaining why you cannot follow it, with a copy to the coding manager. That protects you, and it protects the hospital from claims that could later be treated as false.

Slide 6: Situation 2, The Coworker's Record

A colleague is admitted after a car accident

Staff ask a release of information specialist to check how they are

Principles: 1 (privacy), 3 (protect information), 13 (dignity)

Speaker notes: In the second situation, a well-liked colleague from our department is admitted after a car accident. Several coworkers are worried, and one asks the release of information specialist, who has access to the whole record, to check the chart and let everyone know how the colleague is doing. The request comes from kindness. But the specialist has no work reason to open the record, and the colleague has not chosen to share their condition. Opening it would violate the first and third principles of the code, and it would also be an impermissible use of protected health information under HIPAA.

Slide 7: Situation 2, What To Do

Access only what your job requires, for every patient

Redirect concern: a card, a message through family, not the chart

Remember: every access is logged and audited

Speaker notes: The answer is simple, even if saying it is not. Decline, kindly, and suggest another way to show concern, such as a card or a message through the colleague's family. It is worth reminding coworkers that every access to the record is logged and that the hospital audits access to employee records routinely. The same rule applies to famous patients, neighbors and relatives: we open a record only when our work requires it. Respecting a colleague's dignity includes letting them decide what others know.

Slide 8: Situation 3, A Request to Change a Note

After a fall with injury, a physician asks HIM to remove a signed progress note

The note says the patient was left without fall precautions

Principles: 3 (preserve information), 4 (do not conceal)

Speaker notes: In the third situation, a patient falls and breaks a wrist. The next day, a physician calls the HIM department and asks that a signed progress note be deleted because it states that fall precautions had not been ordered. The physician says the note was written in haste and is misleading. Removing or altering a signed entry after an adverse event would conceal information and damage the integrity of the legal health record, and it could expose the hospital to charges of spoliation if the record is later used as evidence. The code's third and fourth principles are directly at stake.

Slide 9: Situation 3, What To Do

Signed entries are never deleted

Corrections are made by a dated, signed amendment or late entry

Notify risk management; follow the amendment policy

Speaker notes: Explain to the physician that signed entries cannot be deleted, but that the policy allows a correction. The physician may add a dated and signed addendum that clarifies the earlier note, and the original remains visible. This is how a record stays trustworthy: every change can be seen and every author identified. Because the request followed an adverse event, notify risk management, which will already be reviewing the fall. Handled this way, the physician's concern is addressed without compromising the record.

Slide 10: Situation 4, A Family Member's Request

An adult son asks for his father's records to 'help with his care'

The father is competent and has not named him as a representative

Principles: 1 (privacy), 2 (service), 13 (dignity)

Speaker notes: In the fourth situation, an adult son comes to the release of information window and asks for copies of his father's recent records. He is clearly worried, he knows the father's history and he says he is helping with his care. The father is competent, is still a patient and has not given written authorization or named his son as a personal representative. The desire to help is genuine, and the second principle asks us to put service first. But service here means service to the patient, and the patient has the right to decide who sees his information.

Slide 11: Situation 4, What To Do

Explain the rule kindly; do not release

Offer the authorization form for the father to sign

Suggest the son ask his father, or the care team with the father's agreement

Speaker notes: Explain to the son, without judgment, that we can release records only with his father's written authorization or when someone has legal authority to act for him. Give him the authorization form to take to his father, and suggest that if his father agrees, the care team can include him in conversations. This keeps the father's control over his information and still helps the family. If the father lacks capacity, a different process applies, involving his legally recognized representative.

Slide 12: Common Threads

Ethical problems usually arrive as reasonable-sounding requests

The code gives the questions: whose information, what purpose, who decides

Saying no is easier with a clear policy and a manager's support

Speaker notes: Across the four situations, notice three things. Each request came from someone with a reasonable-sounding motive: revenue, concern, a correction, family care. Each could be resolved by asking whose information it is, what the legitimate purpose is and who has the right to decide. And each was easier to handle because a policy existed. Ethics in our work is not usually about dramatic choices. It is about small refusals made politely and backed by the department.

Slide 13: Where To Go for Help

Your supervisor or the HIM director

The compliance hotline, anonymous if you prefer

The privacy officer and risk management

Annual ethics refresher with case review

Speaker notes: When you are unsure, you do not have to decide alone. Start with your supervisor or the HIM director. For concerns about billing or coding pressure, the compliance hotline accepts anonymous reports, and the hospital's policy protects people who report in good faith. The privacy officer handles questions about access and disclosure, and risk management handles adverse events and record corrections. We will review a new case at each annual refresher, and I encourage you to bring situations from your own work.

References

American Health Information Management Association. (2016). AHIMA standards of ethical coding (2016 version). https://bok.ahima.org/topics/coding-compliance-and-revenue-cycle/american-health-information-management-association-standards-of-ethical-coding-2016-version/

American Health Information Management Association. (2019). AHIMA code of ethics. https://bok.ahima.org/topics/industry-resources/code-of-ethics/

National Center for Health Statistics. (2025). ICD-10-CM official guidelines for coding and reporting FY 2026. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/icd/icd-10-cm/index.html