More than Meaningful Use of electronic health records, overall healthcare reform, or the prospect of deep reimbursement cuts, the transition to ICD-10 coding is the "most impactful" issue confronting physician practices today, according to a survey by EHR and practice management software vendor Vitera Healthcare Solutions.

Vitera, based in Tampa, Fla., surveyed 394 physicians and medical office staff nationwide and found that 85% of respondents named ICD-10 and the related ANSI X12 version 5010 transaction sets among the top three issues affecting their practice.

According to the survey, practice managers said they were concerned with the workload involved in coordinating staff training and managing upgrades to IT systems that support ICD-10 coding. Billing managers cited changes to their work processes and uncertainty about whether their practices could handle the changes without suffering a slowdown in cash flow. Physicians indicated that they were worried ICD-10 would take away from the time they have to see patients.

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Many practices will in fact have to modernize their technology, but they may still be waiting on their vendors. The survey found that 59% of physician practices plan on upgrading or replacing their practice management or clinical financial systems in order to code in ICD-10, but 64% said that they already use the most current version of their practice management software.

Only a quarter of respondents said that they were far along on ICD-10 compliance. The larger the practice, the greater sense of urgency regarding the new coding scheme, largely because the switch would require more staff training. Nearly four of every five practices that have coders on staff expect to have to recertify those employees for ICD-10, Vitera reported. About 39% of those surveyed employ certified clinical coders, and only 2% of those that don't plan on hiring one.

"The objective of the study is to help Vitera understand the core issues preventing physicians from upgrading their software regularly," Vitera CEO Matthew Hawkins said in a statement. "The industry is undergoing major shifts that are changing the way things are done in healthcare."

The poll came out prior to the announcement that the U.S. Department of Health and Human Services (HHS) would push back the ICD-10 implementation deadline, which currently stands at Oct. 1, 2013. HHS already has put a three-month hold on enforcement of the 5010 transaction standards, a grace period scheduled to expire March 31.

"Even though implementation of 5010 transactions currently remains in the spotlight, as an industry we need to be prepared for what's to come after March 31," Hawkins said in the company statement. Vitera executives were not immediately available for further comment.

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