Janice Jacobs minces no words about the impact of ICD-10, the forthcoming update to the nation's procedure and diagnosis classification and coding system. And while much has been written about the transition, and some organizations are up to their elbows in planning, it never hurts to be reminded of the impact.

"It's a change of such momentous proportion," says Jacobs, director of IMA Consulting. "It is unlike anything that has happened to the industry." Even the introduction of diagnosis-related groups, the foundation of prospective payment, pales in comparison, she adds. "DRGs did not affect every single department like I-10. This is a change that will affect every single functional area in the hospital, every person and system that touches a claim. We don't really know what will happen in 2014. I do envision a lot of claim rejections."

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