Where to begin? When to begin? How to begin? It wasn’t that long ago when we thought ICD-10 was a very distant nightmare. Coding professionals had heard the song before, and many hoped it would just go away, like it did in the early 1990s. Reality check!! It is coming, sooner rather than later. We are a little more than two years away from a major transformation in coding diagnosis, signs and symptoms, and any condition now covered by the ICD-9-CM codes. You will ultimately need people who are committed to the success of the ICD-10 initiative and have the mindset, knowledge, and tools necessary to achieve the desired results.