1. Summarize the case in a few words.
2. What are the ethical issues associated with this case?
3. Identify the ethical question.
4. What are the facts?
5. Who are the stakeholders?
6. What are the options?
7. What is the decision (HIM values at stake)?
8. What justifies the choice?
9. What can be done in terms of prevention, so the issue is not repeated?

Kelly was a new coder who had never held an HIM job before. She had just graduated from college and passed her RHIT when she was hired by a local clinic and was so excited to start working. A few weeks later, her manager asked to meet with her. The manager closed the door and told Kelly that she wanted her to code charts for a particular procedure using two codes instead of one so the reimbursement would be higher. The manager then divulged information that the clinic was struggling financially, so anything extra would help. Kelly got the impression that if she did not comply, they would let her go, and she needed this job. Also, since her boss asked, she felt obligated.