In August, medical practices received some good news when the Department of Health and Human Services (HHS) pushed back the compliance deadline for the switch from the ICD-9 coding system to ICD-10. The deadline, which was originally set for October 2013, is now October 2014. However, results from a new survey suggest that the extra year has done little to allay concerns. Nuesoft Technologies surveyed 480 physicians, administrators, office managers, and billers and found that 96% of respondents said they are concerned about the impact the transition will have on their practice. More than half (60%) said they are “significantly” or “highly” concerned. Medical practices are right to be concerned. The ICD-10 switch creates a whole host of challenges. First of all, the system contains roughly 155,000 codes, which is a drastic difference from the 17,000 codes found in the ICD-9 system. The increase in codes allows providers to report a more detailed picture of each patient encounter. For example, the ICD-9 code used to report a burn on the right arm is the same for the left arm. The ICD-10 codes not only differentiate between left and right, they include characters that identify other clinical information. Training staff on the new coding system is also requires a significant investment of time and money. Not only will coders need training on how to use the new code system, physicians will also need training on how to improve their documentation. After all, physicians must provide more specific documentation so that the coders will have the information needed to assign the right code. Software programs that practices use to assist in coding claims will also need to be either replaced or upgraded to support the new coding system. Although the change to ICD-10 is a significant challenge for practices, The Centers for Medicaid and Medicare Services (CMS) believes it is worth the investment. The more specific codes will provide healthcare providers and health plans with better information, which will allow for better case management and care coordination. If the switch to ICD-10 goes as planned, the US will become the last developed nation to adopt the ICD-10 system. There is still no timeline set for the conversion to the metric system.