So many maxims and analogies could be applicable to tackling the daunting work of switching the ICD-9 set of codes for ailments and treatments to ICD-10.

The one that keeps recurring to me comes from an old hiking guide.

I remember getting ready to hike Mount Madison years ago. It’s part of the Presidential Range in New Hampshire’s White Mountains that also includes Mount Washington, Mount Adams and Mount Monroe. It’s no Everest, but at 5,367 feet and on a mountain that claims some of the worst weather most of the year, it poses a challenge for inexperienced hikers. The guidebook called the climb an “unrelenting uphill grind,” even “grueling.” It also suggested a way to approach it. “Put one foot in front of the other.” It was such simple advice that it made Mount Madison seem doable – and it was.

That guidance, it seems, could apply to any daunting task – ICD-10, perhaps.

The last time the Department of Health and Human Services extended the compliance deadline in January 2009, it did so by two years. If it had not, the country would already be using the ICD-10 codes today, as the deadline for compliance would have been Oct. 1, 2011.

ICD-9 consists of 17,500 codes, while ICD-10 has about 157,000 codes. However, ICD-9 is 30 years old, and ICD-10 offers the granularity and specificity that ICD-9 does not. The additional codes will help to enable the implementation of electronic health records because they will provide more detail in the electronic transactions, proponents say. This granularity will also help to identify specific health conditions. Also, the greater precision that ICD-10 codes provide is viewed as a way to provide better public health statistics and a way to support value-based purchasing.

No one is arguing the switch will be easy or cheap. It’s likely to be complicated and difficult – even grueling. It’s also likely to be expensive both in labor and software costs for the conversion and also in anticipated loss of productivity during and after the switch. Stormy weather.

But many industry insiders argue that the difficulty and the cost would only increase with time. There’s no time like the present, they say.

The United States, the one industrialized country that has yet to adopt ICD-10, has managed to avoid it for 23 years. It’s been that long since the code set first became available. It’s true that it is a more complex and risky proposition for the United States than for other countries because in the United States the coding system is used for billing as well as for gathering data. If done too rapidly, critics suggest, the switch could paralyze the healthcare insurance payment system.

Twenty-three years without action.

We know ICD-10 is not going away. Federal officials say there will be no pushing of the Oct. 1, 2013 deadline this time as there was time and again with the other deadlines. Why should there be yet another delay? It’s true that healthcare organizations have plenty on their plate with HIPAA 5010, meaningful use, healthcare reform and dozens – perhaps hundreds – of IT projects under way and planned. But if now is not a good time, when would be?

ICD-10 was the talk of the annual AHIMA convention last month. Take Rita A. Scihilone’s advice. Scihilone is senior advisor, global standards for AHIMA.

“What is necessary for a successful transition to ICD-10, she says, is mostly planning. “You need plans. You need a budget. You need preparation. You need to have your training lined up.”

There’s no escaping ICD-10. Start the climb today. Put one foot in front of the other, and keep going. ICD-11 is just around the bend.