The American Academy of Professional Coders, which in April released a five-year training plan to prepare coders and physicians for ICD-10, recommends all practices start analyzing how the expanded code sets will affect them, but small practices should not begin training until at least six months prior to implementation.

ICD-10 consists of 120,000 disease and diagnostic codes, while ICD-9 has only 13,600. Deborah Grider, vice president of strategic development at the AAPC, recommends all practices should begin developing a budget, formulating a training plan, and discussing updates with their software and computer vendors. But the specific code training shouldn't begin yet.

"If the practice begins training on the coding and does not use it for four years, retraining will need to occur," she says.