Search Results. 1 A diagnosis of diabetes is established based on symptoms of hyperglycemia accompanied by an elevated glycated hemoglobin (HbA1c) ≥6. This was the first year ICD-10-CM was implemented into the HIPAA code set. 500 results found. 36 to 2. 3% of deaths globally and an estimated 4. 41. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. Persons with potential health hazards related to family and personal history and certain conditions influencing health status. 5%, a fasting plasma glucose ≥ 126 mg/dL, a 2-h plasma. " Sharing this diagnosis include hypoglycemia, hyperglycemia due to steroids, prediabetes, and over 20 other symptoms. GCs may be used as replacement therapy in people with adrenal insufficiency. On the other hand, I have seen 'diabetes type 2 - uncontrolled due to steroids". For such conditions the ICD-10-CM has a. 29 should only be used for claims with a date of service on or before September 30, 2015. The International Classification of Diseases, 10 th Revision (ICD-10) originally was authorized by the World Health Organization for mortality coding and classification from United States death certificates. Synonyms: diabetic - poor control, hemoglobin a1c - diabetic control. Martha Funnell is an assistant research scientist at the University of Michigan Medical School in Ann Arbor, Mich. 046), lower median blood glucose prior to combination therapy on day 3 (111 mg/dl [96–160] vs. The reason why there is no code for this condition is because. 65, or E11. During cytotoxic chemotherapy, acute hyperglycemia happens frequently and transiently. One symptom of the disease is high blood sugar. This is the American ICD-10-CM version of - other international versions of ICD-10. Billable Code. This is the american icd-10-cm version of e87. Although the total daily dose of insulin may be high, the insulin dose per kilogram is less remarkable. 04. Hyperglycemia due to steroid; Hyperglycemia due to steroid induced diabetes mellitus; Hyperlipidemia due to steroid; Hyperlipidemia, long term steroid use; Left corticosteroid induced cataract; Left residual stage steroid induced. 37X9 With mild nonproliferative retinopathy, with macular edema E10. 49 may differ. HHS happens when your blood glucose (sugar) levels are too high for a long period, leading to severe dehydration and confusion. E11. 816. Best answers. 2024 ICD-10-CM Diagnosis Code. 22 Health service area to show the underlying cause. 39 became effective on October 1, 2023. Quintanilla-Flores DL, Rodríguez-Gutiérrez R, González-González JG, Tamez-Peña AL. Hyperglycemia is associated with increased morbidity and mortality in non-critically ill hospitalized patients [1–3]. Just like 250. 65 [convert to ICD-9-CM] Type 1 diabetes. 65 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 500 results found. Acute lactic acidosis. , steroid induced; Glucocorticoid high dose induced myopathy; Hyperglycemia due to steroid; Hyperglycemia due to steroid induced diabetes mellitus; Hyperlipidemia due to steroid; Hyperlipidemia, long term steroid. Kind Csabooster : Diabetes Mellitus (Dm), Commonly Referred To As Diabetes, Is A Group Of Metabolic Diseases In Which There Are High Blood Sugar Levels Over A. E932. 2 - other international versions of ICD-10 E16. O99. • The dose of sulfonylureas to treat severe or symptomatic hyperglycemia is higher than initial therapy for mild to moderate hyperglycemia. 65 is a valid billable ICD-10 diagnosis code for Drug or chemical induced diabetes mellitus with hyperglycemia . ICD 10 code for Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene. 4 - other international versions of ICD-10 Z79. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. CPT Codes for Pap Smear Collection, Screening CPT codes for Pap smear are (88141-88175) and HCPCS Codes use to report for both screening and Diagnostic pap smear. ICD-10-CM Diagnosis Code. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM. 30, 31, 32 The bidirectional relationship of COVID-19 and DM has been described; hyperglycemia can occur in patients with and without pre-existing DM and is an independent risk factor for worse outcomes in COVID-19. ICD-10-CM Codes. 790. E08. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y89 are recorded as 'diagnoses' or 'problems'. Keywords: steroid induced hyperglycaemia, hospital, practical guide. Use Additional. 65 is a billable diagnosis code used to specify a medical diagnosis of drug or chemical induced diabetes mellitus with hyperglycemia. This is the American ICD-10-CM version of J45. 10 Diabetes mellitus due to underlying condition with ketoacidosis without coma E08. The incidence of glucocorticoid-induced hyperglycemia has been reported to be 12% []. codes for associated manifestations, such as: obesity (. This is the American ICD-10-CM version of E16. Excess cortisol (the “stress hormone”) or growth hormone, for example, can lead to high blood sugar:E11. E13. Patients with type 2 diabetes with generalized obesity or with central overweight, often with nonalcoholic fatty liver disease, frequently require insulin doses in the range of 65 to 100 units per day or much higher. Hyperglycemia is very common during the early posttransplant period, with ∼90% of kidney allograft recipients exhibiting hyperglycemia in the first few weeks following transplant (114–117). Hyperglycemia, primarily resulting from impaired glucose transport into muscles, is a common adverse effect [19]. 39 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Patient is admitted with hyperglycemia due to new-onset diabetes, type 2. Z codes represent reasons for encounters. J45. C. Hyperglycemia; Hyperglycemia (high blood sugar); Hyperglycemia due to steroid; Nutrition therapy for pre-diabetes done; Nutritional therapy for pre-diabetes; Steroid induced hyperglycemia. This is the American ICD-10-CM version of E88. Other hormones can contribute to the development of hyperglycemia as well. Chronic use, defined as therapy greater than 3 months, has been implicated in complications including increased hospital length of stay (LOS), infections, and even death. ICD-10 . Hyperglycemia Icd 9 Code. The 2024 edition of ICD-10-CM Z91. G93. Lowering blood sugar to prevent these complications is a major goal. ICD-10. aspiration pneumonitis due to anesthesia complicating labor and delivery (O74. Drug Or Chemical Induced Diabetes Mellitus With Hyperglycemia. Coding methodology for severe hypoglycemia and hyperglycemia changed between 2015 and 2016 due to transition from ICD-9 to ICD-10 codes, affecting hypoglycemia ascertainment more than severe hyperglycemia due to greater availability of hypoglycemia ICD-10 codes than ICD-9 codes. Diabetic ketoacidosis (DKA) is associated with hyperglycemia and ketoacidosis, whereas hyperosmolar hyperglycemia state (HHS) mainly has severe hyperglycemia and hyperosmolarity. R10. Steroid induced Type 2 diabetes. In univariate analysis, patients who achieved euglycemia had significantly higher median NPH dose standardized to steroid dose on day 1 (0. 241. This is the American ICD-10-CM version of H40. Other hydronephrosis. ICD-10-CM Code for Type 1 diabetes mellitus with hyperglycemia E10. Hyperglycemia is associated with increased hospital complications and mortality in patients receiving TPN. The 2024 edition of ICD-10-CM E11. 0. The 2024 edition of ICD-10-CM E78. 49 - other international versions of ICD-10 G93. In ICD-10-CM, chapter 4, "Endocrine, nutritional and metabolic diseases (E00-E89)," includes a separate subchapter (block), Diabetes mellitus E08-E13, with the categories: E08, Diabetes mellitus due to underlying condition; E09, Drug or chemical induced diabetes mellitusIntroduction. This is the American ICD-10-CM version of I15. Small vessel disease due to type 2 diabetes mellitus; ICD-10-CM E11. b. 9. ICD-10-CM Diagnosis Code E09. Cerebral infarction due to embolism of middle cerebral arteryIn early studies regarding COVID-19, type 2 diabetes mellitus was considered to contribute substantially to the disease’s inflammatory response. Chronic metabolic acidosis. 65 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM M81. Hyperglycemia, unspecified. Hyperglycemia in COVID-19, irrespective of insulin resistance or history of diabetes, is a portent of worse prognosis. This is the American ICD-10-CM version of E13. Search Results. 3% in each category (11 of 32). E09, drug- or chemical-induced diabetes mellitus; e10, type 1 diabetes. steroid-induced diabetes is reported to be 39-78% and 40% in patients receiving steroids due to hematologic, rheumatologic or nephrologic indication. 65 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. TYPE RT LT BOTH SINGLE CODE UNSPECIFIED . The 2024 edition of ICD-10-CM E16. It usually resolves spontaneously, but must be distinguished from various forms of diabetes mellitus. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code B97. 5-27% of patients placed on steroid therapy [3-4]. CONCLUSIONS The risk of ketoacidosis and hyperglycemia should be considered in the course of steroid. Hyperglycemia; Hyperglycemia (high blood sugar); Hyperglycemia due to steroid; Nutrition therapy for pre-diabetes done; Nutritional therapy for pre-diabetes; Steroid. Steroid-induced hyperglycemia is common in hospitalized patients. 31, and a number needed to harm. Short description: Adv eff corticosteroids. 8 became effective on October 1, 2023. Effective Oct. ICD-10-CM Diagnosis Code E10. DM was soon identified as a notable risk factor for severe disease and mortality. Hyperglycemia, unspecified. Type 1 diabetes mellitus with other specified complication. For such conditions, ICD-10-CM has a coding. 10–1. This is the American ICD-10-CM version of E10. 043 may differ. 00. If it is documented as diabetes then code. ICD-10-CM Diagnosis Code E11. 0); aspiration pneumonitis due to anesthesia complicating pregnancy (O29); aspiration pneumonitis due to anesthesia complicating the puerperium (O89. Hyperglycemia; Hyperglycemia (high blood sugar); Hyperglycemia due to steroid; Nutrition therapy for pre-diabetes done; Nutritional therapy for pre-diabetes; Steroid induced hyperglycemia. 043 became effective on October 1, 2023. Showing 1-25: ICD-10-CM Diagnosis Code E10. Corticosteroids, or steroids by short, are a common medication prescribed for a multitude of diseases, but can often cause problems of sugar in the blood for people living with diabetes. ICD-10-CM Diagnosis Code Z87. Z codes represent reasons for encounters. Z92. I know that it was once coded as 251. Recent randomized trials and meta-analyses, however, have raised questions about. Which diagnoses should be reported?. g. Drug/chem diab w mod nonprlf diab rtnop w/o macular edema; Drug induced diabetes. 21 may differ. This is the American ICD-10-CM version of Z79. 1 millimoles per liter (mmol/L). The 2024 edition of ICD-10-CM E87. Type 1 DM • E11 . 2 - other international versions of ICD-10 D70. 4–0. Drug/chem diabetes mellitus w hypoglycemia w coma; Drug induced dm w hypoglycemic coma; Hypoglycemic coma due to drug induced diabetes mellitus. Type 2 diabetes mellitus with diabetic cataract. Exacerbated and uncontrolled hyperglycemia is a common complication in patients with DM and carbohydrate intolerance as previously documented Moreover, DM incidence in patients without a prior history of hyperglycemia to steroid use varies from 34. 00 [convert to ICD-9-CM] Search Results. E09. 909 may differ. 1 became effective on October 1, 2023. Applicable To. Steroid-induced psychosis is considered a type of substance-induced psychotic disorder and is defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). 81 may differ. , and a member of the Nursing2012 editorial board. Use the term hyperglycemia forSteroid-induced hyperglycemia is common in hospitalized patients. This is the American ICD-10-CM version of T81. The former has 14,000 codes, while ICD-10 has over 70,000. 80 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 250. ”. - Type 2 Diabetes mellitus with Y42. The term "hyperglycemia" is derived from the Greek hyper (high) + glykys (sweet/sugar) + haima (blood). Codes; Modifiers; License Data Files; Disclaimer; Search Results. g. patient with. 21 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Hyperglycemia, unspecified. 69 Drug. The 2024 edition of ICD-10-CM I24. Symptoms of hyperglycemia develop slowly over several days or weeks. ICD-9-CM 250. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, categorizes steroid-induced psychosis as a form of substance/medication-induced psychotic disorder. 7 Androgens and anabolic congeners and Y92. 36 (95% CI, 1. E78. Symptoms and signs involving the digestive system and abdomen. It is found in the 2024 version of the ICD-10. In most cases, such stress- or steroid-induced hyperglycemia resolves by the time of discharge ( 117 , 118 ). 4 units/mg PED [0. 99. Steroid-induced hyperglycemia with insulin resistance, lipolysis, and ketogenesis occurred and were likely to have precipitated the ketoacidosis. 72XA - other international versions of ICD-10 T81. However, the exact prevalence of hyperglycemia secondary to glucocorticoid therapy is not known, making this an. Mammalian target of rapamycin (mTOR) inhibitors are associated with a high incidence of hyperglycemia, ranging from 13% to 50%. I15. 500 results found. The 2024 edition of ICD-10-CM D70. 65 is a valid billable ICD-10 diagnosis code for Drug or chemical induced diabetes mellitus with hyperglycemia . 240. 65. ICD-10-CM Diagnosis Code R73. 8]; p = 0. Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye. There is an urgent need to dissipate information about optimum management of hyperglycemia during steroid use. Less common risk factors include excessive alcohol use, physical inactivity, being. Diabetes type 2 with hyperglycemia; Hyperglycemia due to type 2 diabetes mellitus. E09. Code History. 72XA became effective on October 1, 2023. 00. 500 results found. 65 for Drug or chemical induced diabetes mellitus with hyperglycemia is a medical classification as listed by WHO under the range - Endocrine, nutritional and. 5, and this ratio can reach 10. 9 [convert to ICD-9-CM] Hyperglycemia, unspecified. This is the American ICD-10-CM version of E10. ICD-10-CM Diagnosis Code R73. 0X5A. ICD-9-CM E932. Search Results. Available for iPhone, iPad, Android, and Web. 9. All neoplasms, whether functionally active or not. 65 may differ. 65 - other international versions of ICD-10 E09. Adrenal insufficiency is a condition in which the adrenal glands do not produce adequate amounts of steroid hormones, primarily cortisol; but may also include impaired production of aldosterone (a mineralocorticoid), which regulates sodium conservation, potassium secretion, and water. Stress-induced hyperglycemia (SIH) was. SIHG,. 2% (highest) in the. E09. 2016. Lymphocytosis. 5 - other international versions of ICD-10 E78. R79. Type 2 diabetes mellitus – steroid induced ; publication date: september 2013 ; icd 10 am edition: seventh edition ; retired date: 30/6/2017 ; query number: 2784. Despite their proven efficacy, glucocorticoids bear a wide variety of side effects among which steroid induced hyperglycaemia (SIHG) is among the most important ones. 29: “Other abnormal blood glucose. 909 - other international versions of ICD-10 J45. Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. A recent study suggests that even a few days of hyperglycemia have deleterious effects on the immune system. 40 - other international versions of ICD-10 G93. R73. This is the American ICD-10-CM version of E16. Blood glucose, blood gases, and urine test results were diagnostic for ketoacidosis. 0X5A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. While ICD-10-M is used for mortality statistics, ICD-10-CM [clinical modification] is used for. There is an urgent need to dissipate information about optimum management of hyperglycemia during steroid use. for ICD-10-CM and ICD-10-PCS (ICD-9) 3,895 articles since 1984. Hypoglycemic Agents. ICD-9-CM 249. 10. A corresponding procedure code must accompany a Z code if a procedure is performed. 36 - other international versions of ICD-10 E11. The 2024 edition of ICD-10-CM E11. Abstract. 81 is a new 2024 ICD-10-CM code that became effective on October 1, 2023. 22 may differ. , type 1, type 2, gestational diabetes mellitus, pancreatic diabetes) when it is known. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). 65 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. a) Fasting glycemia. [convert to ICD-9-CM]Anabolic steroid icd 10. According to the American Diabetes Association (ADA), approximately 10% of people who are initiated on glucocorticoid (also referred to as corticosteroid) therapy while in the inpatient setting experience hyperglycemia. 3% of patients with colorectal cancer during chemotherapy, respectively. ICD-10-CM Diagnosis Code E11. Z79. ICD 10 AM Edition: Seventh edition Retired Date: 30/6/2017 Query Number: 2784. 65 [convert to ICD-9-CM] Type 1 diabetes mellitus with hyperglycemia. 1 may differ. Despite their proven efficacy, glucocorticoids bear a wide variety of side effects among which steroid induced hyperglycaemia (SIHG) is among the most important ones. 618. Source ICD-10-CM Code Target ICD-9-CM Code; T38. ICD-10-CM Diagnosis Code R73. This article aims to review the pathogenesis, risk factors, diagnosis and treatment principles unique to steroid-induced diabetes. 620 Drug or chemical induced diabetes mellitus with diabetic dermatitis. Hyperglycemia; Hyperglycemia (high blood sugar); Hyperglycemia due to steroid; Nutrition therapy for pre-diabetes done; Nutritional therapy for pre-diabetes; Steroid induced hyperglycemia. 1 For steroid-induced psychosis to be diagnosed, a number of criteria must be met. 4. Road to 10, a CMS online tool built with physician input. Code History. 43 is grouped within Diagnostic Related Group(s) (MS-DRG v 41. 9 [convert to ICD-9-CM] Hyperglycemia, unspecified. The code is valid during. In ICD-10-PCS, if a character is not applicable, the letter. or uncontrolled •The Alphabetic Index instructs: - Zout of control should be coded to diabetes, by type, with hyperglycemia - poorly controlled should be coded to diabetes, by type, with hyperglycemia . E09. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Abnormal glucose NEC. This is the American ICD-10-CM version of E78. 65 may differ. Search Results. We propose a relatively simple schema for the proactive management of corticosteroid-induced hyperglycemia that has been effective and easily adaptable to both the inpatient and the outpatient setting. R73. Steroid hyperglycemia: Prevalence, early detection and. ↓ See below for any exclusions, inclusions or special notations. Lazar et al. 65. 21) requires theDiabetes due to underlying condition w hyperglycemia. Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified. 3X5A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. , 305. 641 [convert to ICD-9-CM] Drug or chemical induced diabetes mellitus with hypoglycemia with coma. G92. What are the functions of ICD-10 for prediabetes?Hyperglycemia is most common during the induction phase of therapy likely due in part to the use of medications including glucocorticoids and asparaginase products. [convert to ICD-9-CM]Type 2 diab w hyprosm w/o nonket hyprgly-hypros coma (NKHHC); Diabetes type 2 with hyperosmolarity; Hyperosmolarity without nonketotic hyperglycemic hyperosmolar coma due to type 2 diabetes mellitus. 041 [convert to ICD-9-CM] Steroid responder, right eye. 29: "Other abnormal blood glucose. 1 - other international versions of ICD-10 R79. Hyperglycemia; Hyperglycemia (high blood sugar); Hyperglycemia due to steroid; Nutrition therapy for pre-diabetes done; Nutritional therapy for pre-diabetes; Steroid induced hyperglycemia. Search Results. 2 became effective on October 1, 2023. Non-pressure chronic ulcer of unsp calf with unsp severity; Atherosclerosis native artery of leg, calf ulcer; Atherosclerotic ischemic ulcer of calf; Diabetes type 1 with diabetic ulcer of calf; Diabetes type 2 with diabetic ulcer of calf; Diabetic ulcer of calf due to dm 1; Diabetic ulcer of calf due to dm 2; Neuropathic ulcer of calf; Ulcer calf, chronic; Ulcer of calf; Ulcer. 29 - Adv eff med/biol NEC/NOS: Combination Flag - Multiple codes are needed to describe the source diagnosis code. Adverse effect of glucocorticoids and. Search Results. 37X2 E10. 8 became effective on October 1, 2023. 11:. If glycaemic control is not achieved, evening dose of gliclazide can be added and intermediate-acting insulin considered. ICD Code T38. It is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin. We implemented a protocol for detection and management of SID and steroid-induced hyperglycamia (SIH) in h. 649 became effective on October 1, 2023. But more commonly, they are. 2); anaphylactic reaction or shock NOS. 988 may differ. 2 became effective on October 1, 2023. ICD-10-CM Codes. . 9. Synonyms: acute hyperglycemia, chorea due to hyperglycemia, chorea due to metabolic. ICD-10 Clinical Concepts for Internal Medicine is a feature . 65 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code E09. 280 became effective on October 1, 2023. The following are 10 commonly used hyperglycemia ICD Codes: R73. The limited data available suggest that glycemic control in patients with COVID-19 is inadequate. E16. Hyperglycemia is defined as blood glucose > 140 mg/dl, and treatment is recommended when glucose levels are persistently > 140–180 mg/dl. 9. Diseases of the pancreas. DM types are divided into five categories: • E08. Showing 1-25: ICD-10-CM Diagnosis Code R73. This is the American ICD-10-CM version of G93. ICD-10-CM Code for Adverse effect of glucocorticoids and synthetic analogues, initial encounter T38. Patient has had polydipsia, polyuria, and unexplained weight loss. CHARACTERIZING HYPERGLYCEMIA. Use Additional. 7 Glucocorticoids are a common cause of new-onset hyperglycemia in hospitalized patients, and new-onset hyperglycemia is associated with an increased risk of morbidity and mortality compared with chronic. The 2024 edition of ICD-10-CM M79. 0):. Total glucocorticoid dose and duration of therapy are strong predictors of diabetes induction. High dose steroids (HDS) are used in the treatment of haematological malignancies. 0X5 is a non-billable code. ICD-9-CM 790. Glucocorticoids (GC) such as prednisone, dexamethasone and hydrocortisone, are potent anti-inflammatory and immunosuppressive agents, thus effective for treating a wide spectrum of diseases. 9 became effective on October 1, 2023. 9, to enhance healthcare accuracy and patient outcomes. Vitreous hemorrhage due to type 2 diabetes mellitus; ICD-10-CM E11. 10 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. This is the American ICD-10-CM version of N13. 65 became effective on october 1, 2022. A week after taking metformin, she noted increased episodes of palpitations, dizziness, and diaphoresis, which were relieved with food intake. Continue reading >>. If glycaemic control is not achieved, evening dose of gliclazide can be added and intermediate-acting insulin considered. Nov 4, 2011. Discussion. 321. Applicable To. D70. cortisol) and sex steroids (e. 606 became effective on October 1, 2023. Previous studies show that 53–70% of individuals without diabetes develop steroid-induced hyperglycemia ( 42 ). The steroids were taken correctly. 2 - other international versions of ICD-10 E78. 2–0. 65 is a billable diagnosis code used to specify type 2 diabetes mellitus with hyperglycemia. Acute toxic-metabolic encephalopathy (TME), which encompasses delirium and the acute confusional state, is an acute condition of. The 2024 edition of ICD-10-CM N13.