Question

Matthew is a new coder at Cengage General Hospital. His manager really likes his positive, can‐do
attitude and willingness to learn. Currently, Matthew is coding Emergency Department (ED) visits. He
likes coding EDs as they offer a lot of diversity and he finds them interesting. One day, while coding the
EDs, he recognized the name of his sister, Julia, who just got married 6 months ago. He read through
Julia’s visit with great interest. She was 3 months pregnant! He was going to be an uncle! As he started
to code her visit, he realized she was having complications with the pregnancy. The ED physician’s final
diagnosis was threatened abortion. He was very sad when he read this. He quickly picked up his cell
phone to call his mother, and then his sister.

1. Should Matthew tell his mother, and then call his sister? Would this be considered a HIPAA violation?
Why or why not?

2. Is it a good idea for him to code his sister's record? What should he do in this situation?

Answer 1

ANSWER 1; YES, IT WILL BE CONSIDERED AS HIPPA VIOLATION BECAUSE:

HIPPA regulations has 150 pages that contains many provision and rules that can be violated and need compensation for it. Impermissible disclosure of health information related to patient is one of the HIPPA violated rules. There is a provision of no sharing data about the patient to the third party who is not related to his/ her health. This will consider a breach of confidentiality. If patient give permission to the physician to share her health conditions and news with other members than only the physician is eligible to share his/her health status unless it is not a case of genetic consideration or serious health issues.

ANSWER 2: NO, generally physicians should not treat or code the diagnosis of their own blood relative people, because:

• it may influence the feelings of physician
• can interfere in making decision and judgment
• the sensitive case can probe the physician and make unable to do private assessment and examinations
• a physician can become sensitive during disclosing the bad or sensitive information.
• intimate care may be impossible
• tensions can develop between the relationship of family members and physician

IN these case physician should :

• seek help from others
• make primary physician to another skilled doctor
• if given care during an emergency case, then document and provide relevant information to the primary physician about patient
• advocate the patient and family, help in decision making and can communicate with primary physician if the patient allows or wishes.
• If the condition is serious make stabilized conditions then only make a referral to other consultants and specialists.