Industry sentiment on ICD-10 spans the entire spectrum. At one end, some describe it as a potential train wreck. At the other, some say the intricate coding and nomenclature system--which is mandated to take effect industry-wide on Oct. 1, 2013--is the industry's best shot at improving the way it describes, bills and pays for services.

The skeptics fear a revenue cycle nightmare in which payments are stalled. The idealists envision a new era of improved documentation, quality and outcomes. A large group in the middle has no time for theorizing, since they're already submerged in making the transition. A few CIOs are beginning to plead for an extension of the deadline.

No one knows how things will ultimately shake out, just as no one can lay claim to being fully prepared. But even the most devoted proponent of ICD-10 acknowledges that the path to attaining it is laden with pitfalls-if not landmines.

"Here Comes Trouble," Gary Baldwin's cover story in the December issue of Health Data Management, summarizes 10 key hurdles ICD-10 represents. Two accompanying stories include a primer of five lessons gleaned from organizations trying to make the transition as smooth as possible, and a defense of migration to ICD-10.


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