Case Study
Jane’s primary care physician has submitted many of these diagnostic tests for prior authorization to her
insurance company, yet there are rejections of routine studies that must be submitted multiple times before
they are approved. This causes delays in her care. Nothing substantial, but it proves to add stress and
repetitive work for many of the parties involved.
Questions to Consider

1. What are some of the benefits of ICD-10-CM vs ICD-9? What do these changes hope to accomplish?
2. Who benefits from increased detail in clinical coding? Is anyone hurt by these changes?