When it comes to describing ICD-10's impact on the revenue cycle, Rich Silveria paints with a broad brush. "The impact will be pervasive," says Silveria, corporate director of revenue finance at Partners HealthCare System, Boston. "It touches all the information systems within a provider, except maybe payroll and accounts payable. It is an enormous amount of work, a large complicated project. And my intuition is that most providers have underestimated the effort to get it done."

Silveria speaks from experience. Partners is among only a handful of hospitals that have begun the transition work to the new coding and reimbursement nomenclature, which is mandated by the Centers for Medicare & Medicaid Services to take effect by in October 2013. A variety of industry surveys-from WEDI and other groups-suggests that the industry is falling behind the necessary preparation for the change, whose first step is implementing the HIPAA 5010 claims transaction standard.

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