Many in the industry are realizing just how expansive the impact of ICD-10 actually is. And it’s a good thing, because the new code set—which takes effect in October 2013—contains tens of thousands of new, highly granular codes to denote diagnoses and procedures. Because of the scope of the remediation and training work involved, experts say that organizations need to become extremely methodical in their management of the transition, laying out systems inventories, remediation plans, budget estimates and labor allocations. Some are already calculating the impact of a major productivity decrease, certainly on the part of coders, and likely on the part of the physicians, who will be asked to document to an unprecedented level of detail about what they do and why.

The starting point, experts say, is establishing high-ranking executive sponsorship of the ICD-10 effort. "You need an enterprisewide governance structure to manage the change," says Mark Avery, an I.T. and management consultant with PricewaterhouseCoopers. "ICD-10 is not just a compliance event. It's a compliance event with enterprise impact. "

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