the second postponement in two years. Those organizations that have completed date-sensitive remediation may now face additional work. And there will be a need for additional general equivalence mapping (GEM) between the two standards.

So where does that leave health organizations? The onus is on individual providers and payers to determine a bespoke plan that meets their business needs and timeline. But that plan is likely to fall within one of four possible contingency options:

1. Stay the course: This is likely to be the preferred option of providers and payers that have completed remediation and are now in testing, as this will allow that work to be finalized. Potential disadvantages include the possibility that the readiness of providers and payers is out of step. It's also possible organizations will require additional funding to support the extension, or even that staffing levels may have to be reduced in the hiatus period preceding the compliance date.

2. Slow down: By stretching the work that still to be done over the course of the extension, there may be less need to increase budgets and resources. However retaining staff over the extended timeline may prove difficult, raising other concerns.

3. Be pragmatic: Some organizations may choose to stick to their original timelines where possible, accomplishing what is feasible and realistic this year while reserving a small budget to complete deferred work next year. This will enable them to focus resources on areas according to current readiness levels.

4. Stop: One option is to stop work completely for now, maintaining the budget until a new compliance date is set. This presents organizations not ready for ICD-10 with potential problems such as having to relocate skilled resources once work begins again -- inevitably, the whole program will take time to ramp up. This may be a favored option for organizations that have already completed remediation and external testing.

All four options have pros and cons, which will be more or less significant depending on where the organization currently stands in its preparations. But the delay to ICD-10 is a reality -- and organizations must now decide how to respond.

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