Neovascular amd od icd 10. H 35. Neovascular amd od icd 10

 
 H 35Neovascular amd od icd 10 212 - other international versions of ICD-10 H26

50 became effective on October 1, 2023. 1122 - other international versions of ICD. 051 became effective on October 1, 2023. 342 - other international versions of ICD-10 H35. H35. 3220 may differ. Also called age-related macular degeneration (AMD), the condition is caused by the deterioration of the small central portion of the retina – called macula (the inside back layer of the eye). Choroidal degeneration, unspecified, left eye. Overall, 8 of the 10 eyes with nonexudative CNV developed exudation with a mean time of 8 months and mean CNV area growth rate of 20% per month (P = 0. Dry (nonexudative or atrophic): All age-related macular degeneration (AMD) starts as the dry form. Ophthalmologists at UC Davis Health used an experimental gene therapy last month to treat a patient with wet age-related macular degeneration, or wet AMD. Geographic atrophy (GA) is a late-stage of dry age-related macular degeneration (AMD). 819 - other international versions of ICD-10 H43. The following code(s) above E11. Subfoveal choroidal neovascularization (CNV) is a leading cause of visual loss in the geriatric population []. It was first described by Gass in 1966 [ 1] as a serous elevation of the RPE. Initiation of antiangiogenic treatment halted their growth. 1 million adults age 50 years and older in the US had AMD. Put the anti-VEGF medicine into your eye with a very small needle. Retinal neovascularization, unspecified, right eye. Among the two types of AMD (dry and neovascular), dAMD constitutes the majority (80–90%) of cases and occurs when photoreceptors are lost and drusen (yellow deposits) develop [1, 2]. 3211 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 90 - other international versions of ICD-10 D31. SUBSCRIPTION OPTIONS. (MAC) found in each contractor’s local coverage determination. Wykoff CC, Ou WC, Brown DM, et al. In a Cochrane review on macular translocation for neovascular AMD, Eandi et al (2008) concluded that there is insufficient evidence from randomized. This is the American ICD-10-CM version of D22. Moreover, it was reported that RPD eyes with neovascular AMD had thinner SFCT (145 ± 48 µm) than RPD eyes with dry AMD (201 ± 88 µm) 21. Currently, the approved. Abstract. Diagnosis for age-related macular degeneration (ICD-10-CM): H35. This is the American ICD-10-CM version of H35. To study associations of optical coherence tomography (OCT) features with presenting visual acuity (VA) in treatment naive neovascular age-related macular degeneration (nAMD). ICD-10-CM Code. 3210 is applicable to adult patients aged 15 - 124 years inclusive. Neovascular glaucoma is an aggressive form of secondary glaucoma. AMD is more common among White people and is the leading cause of permanent vision loss in older adults. The 2024 edition of ICD-10-CM H35. H35. Article CAS Google Scholar500 results found. Purpose: To describe the clinical and multimodal imaging (MMI) features of age-related macular degeneration (AMD) eyes presenting with intraretinal exudation and no evidence of neovascularization or structural alterations of native retinal vessels. Macular cyst, hole, or pseudohole, left eye. 3231 is a valid billable ICD-10 diagnosis code for Exudative age-related macular degeneration, bilateral, with active choroidal neovascularization. and neovascularisation. The final changes were posted on the CDC website on August 22, 2016. The 2024 edition of ICD-10-CM became effective on October 1, 2023. Exudative or neovascular AMD is a more severe subset of AMD which is characterized by the presence of choroidal neovascularization (CNV). These new blood vessels may then bleed and leak fluid, causing the macula to bulge or lift up from. 3232 became effective on October 1, 2023. The document has moved here. When you get this treatment, your doctor will: Put numbing medicine in your eye. Neovascular ARMD icd 10's Wiki. Key Points. In absence of a consensus definition, broadly. Evidence supports that symptomatic patients with PCV can have. Currently available treatments for exudative AMD use intravitreal injections, which are associated with high risk of infection that can lead to. While the presence of subretinal fluid often prompts the initiation of intravitreal injections, there are some cases where treatment can be deferred as discussed. They break through the barrier between the choroid and the retina. This is the American ICD-10-CM version of H35. Age-related macular degeneration (AMD) remains a disease with high morbidity and an incompletely understood pathophysiological mechanism. Neovascular glaucoma is a type of secondary glaucoma where the angle of the eye is closed by “new blood vessels,” hence the name “neovascular. Of 51 patients with MNV in the contralateral eye, 23 eyes, 10 eyes, 12 eyes, and 6 eyes showed neovascular AMD, polypoidal choroidal vasculopathy, retinal angiomatous proliferation (RAP), and. The following code (s) above D31. 3223 - other international versions of ICD-10 H35. 52X0 may differ. 3221 ICD-10 code H35. The following are the ICD-10 diagnostic codes for various forms of AMD: AMD (ICD 10 macular degeneration) Coding for Laterality You must use the sixth character to indicate laterality when using ICD 10 codes for macular degeneration, dry AMD (H35. Intermediate Stage. Diagnosis for age-related macular degeneration (ICD-10-CM): H35. 2A9 became effective on October 1, 2023. The risk of late AMD, including nAMD and geographic atrophy, increases exponentially in advanced age. 1 Any stage of dry AMD can turn into wet AMD, which typically causes faster vision loss. These blood vessels grow in an area called the choroid. 6% (19 of 721. 89 is applicable to adult patients aged 15 -. The 2024 edition of ICD-10-CM C96. Indications and Limitations of Coverage. AMD may be classified as early, intermediate, and advanced types based on severity. AMD is classified as either dry or wet (neovascular), and dry AMD may manifest as early, intermediate, or advanced disease. Etiology is unidentifiable in a significant proportion, hence termed as idiopathic. 1 may differ. Policy/Criteria I. A network of abnormal, leaky blood vessels in the choroid is referred to as a choroidal neovascular membrane (CNVM). This may go undetected or undiagnosed. Methods: This was a retrospective review of the MMI and electronic health records for 3 consecutive patients. 3211 became effective on October 1, 2023. 30 may differ. ICD-10-CM Coding Rules. 05 contain annotation back-references that may be applicable to H35. Applicable To. At the initial visit, 19 of the eyes had vision better than 20/200. In the wet form, rapid, severe vision loss can occur due to the development of. H31. The human eye is a wondrous, and wondrously complex, device. Prior treatments have included focal laser therapy, verteporfin (Visudyne. Macula. Furthermore, this study. The higher. ICD-10-CM Coding Rules. Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in the population over 50 years of age [], and neovascular AMD (NVAMD) is responsible for up to 90% of severe vision loss due to AMD [2, 3]. 121 - other international versions of ICD-10 D22. “Inflammatory Choroidal Neovascular Membranes: Clinical Profile, Treatment Effectiveness, and Visual Prognosis”. Short description: Macular degeneration NOS. Neovascular AMD is characterized by choroidal neovascularization (CNV. . 219 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Angiogenesis Inhibitors. Characterized by drusen formation, macular pigmentary changes, geographic atrophy, and neovascularization of the choriocapillaris with exudation. Retinal pigment epithelial detachment is defined as a separation of the retinal pigment epithelium from the inner collagenous layer of Bruch’s membrane. 051 - other international versions of ICD-10 H35. 873 - other international versions of ICD-10 H02. H35. 7%, although it varies significantly among different populations. ICD-10-CM Coding Rules. 4 became effective on October 1, 2023. 61 may differ. Intravitreal injection therapy using anti-vascular endothelial growth factor (VEGF) agents (e. Vascular anomalies of unspecified eye, unspecified eyelid. This is the American ICD-10-CM version of H35. The risk of late AMD, including nAMD and geographic atrophy, increases exponentially in advanced age. All of the DM retinopathy code choices will now specify which eye is impacted. 4 - other international versions of ICD-10 H16. 30 - other international versions of ICD-10 H35. Macular Degeneration is an eye disease that primarily affects the retina and destroys your sharp, central vision. H35. ICD-10-CM Coding Rules. ICD 10 code for Exudative age-related macular degeneration, bilateral, with active choroidal. ICD-10-CM Coding Rules. It is interesting that one study noted increased choriocapillaris non-perfusion compared to fellow non-neovascular eyes, implying that choriocapillaris ischemia may play a critical role in the development of these lesions. 2% and Geographic atrophy in 1 eye being 0. Advanced forms of AMD are seen in primarily two types—neovascular AMD (nAMD) with the presence of choroid neovascularization and non-neovascular AMD (nnAMD) with geographic atrophy. Unspecified retinal break, unspecified eye. The conversion to wet AMD can occur at any stage of dry AMD, but is more likely in. As there are no ICD-10 codes specific for AMD or its type (neovascular or dry), we considered as AMD patients those submitted to one of the two procedures in the public system exclusively available for AMD patients . wet AMD mean? All patients with AMD begin with the non-neovascular, or dry, form. Results: Treatment goals for neovascular age-related macular degeneration include improving/maintaining vision by drying the retina, and several analyses have evaluated the relationship between visual. C72. 3211: 362. Genetic, epidemiological, and molecular studies are beginning to unravel the intricate mechanisms underlying this complex disease, which implicate the lipid-cholesterol pathway in the pathophysiology of disease development. 3223 - other international versions of ICD-10 H35. 50 - other international versions of ICD-10 C72. 051 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Age-related macular degeneration is a potentially progressive maculopathy. Neovascular AMD (nAMD) represents a small subset (less than 10%) of total AMD cases; however, the neovascular form is responsible for the majority of cases of severe visual loss in eyes with AMD . In addition to code changes, some tabular instructions were revised to provide clarity. 329 contain annotation back-referencesThe prevalence of subclinical nonexudative neovascular AMD in the fellow eyes of patients with unilateral exudative AMD ranged from 6. Source ICD-10-CM Code Target ICD-9-CM Code; H35. Wet AMD was coded as H35. 3223 is a valid billable ICD-10 diagnosis code for Exudative age-related macular degeneration, left eye, with inactive scar . 2 A large period of time can elapse between the anatomical onset of the disease and visual deterioration. 3293: Exudative age-related macular degeneration : ICD-10 codes not covered for indications listed in the CPB: H35. 2024 ICD-10-CM Range M00-M99. The neovascular membranes of myopic CNV are typically less than 1,000 μm in diameter, and sub–retinal pigment epithelium (RPE) fluid or exudates are uncommon. 3223. 2 - with inactive choroidal neovascularization with involuted or regressed neovascularization. In the wet form, rapid, severe vision loss can occur due to the development of. Retinal neovascularization, unspecified, unspecified eye. Dry age-related macular degeneration (dAMD) is a chronic eye disease that can impair vision and progress to severe central vision loss []. AMD constitutes one of the leading. This is the American ICD-10-CM version of C72. H35. 3131 contain annotation back-references. H35. 2020 Nov 3;21 (21):8242. MNVs contain blood vessels as well as infiltrating immune cells,. H 35. 30 became effective on October 1, 2023. The dye lights up areas with choroidal neovascularization. The AMD population is expected to be 288 million by 2040 [3, 4]. H35. 3293: Exudative age-related macular degeneration : ICD-10 codes not covered for indications listed in the CPB: H35. 52 or ICD-10-CM code H35. This is the American ICD-10-CM version of H26. Introduction: Wet (neovascular, exudative) age-related macular degeneration (AMD) is a leading cause of severe vision loss in the elderly population of developed societies. 3212 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Age-related macular degeneration (AMD) is a leading cause of visual impairment and blindness in people older than 50 years. ICD 10 code for Exudative age-related macular degeneration, unspecified eye, with inactive choroidal neovascularization. The retina is a layer of neurosensory tissue in the eye that converts light into neural signals that the brain interprets as images. 3213 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. H35. 1 cm/cm 1. Billable/Specific Code. 351 became effective on October 1, 2023. of the disease, since several therapies exist that reduce vision loss once the advanced neovascular form of AMD occurs. 15 At Month 12, eyes gained 10. 25% to 27%. ICD-10 code H35. 2021 May 30;10 (11):2436. D31. H35. 052 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. In the 2021 study, median VA was 20/25-2 among eyes with a known baseline. diagnosis of neovascular AMD (ICD-9-CM code 362. Rheumatic multiple valve disease, unspecified. 30 - other international versions of ICD-10 H35. 052 became effective on October 1, 2023. Short description: Exudative age-rel mclr degn, left eye, with inactive scar The 2024 edition of ICD-10-CM H35. In this investigation, we report on the detection and quantification of key OCT features associated with neovascular AMD with an automated analysis software vs. 1. SIERRA-AMD: a retrospective, real-world evidence study of patients with neovascular age-related macular degeneration in the. H35. 31), waist to hip ratio (HR per 0. The aim of this study was to describe features of disease activity in patients with treated stable macular neovascularisation (MNV) in neovascular age related macular degeneration (nAMD) using optical coherence tomography angiography (OCTA). 059: Retinal neovascularization, unspecified [associated with age-related macular degeneration] H35. 30 may differ. In the “wet” type of macular degeneration, abnormal blood vessels (known as choroidal neovascularization or CNV) grow under the retina and macula. Macular degeneration typically refers to age-related macular degeneration (AMD). Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is an uncommon degenerative process of the retina with sub-retinal or sub-pigment epithelium hemorrhage and exudative mass outside of the macular region. What does dry vs. 3293: Age-related macular degeneration : Background. 219 became effective on October 1, 2023. ICD - 9. Exudative or neovascular AMD is a more severe subset of AMD which is characterized by the presence of choroidal neovascularization (CNV). 1 Polypoidal choroidal vasculopathy (PCV), which presents as a serosanguinous maculopathy, is a variant of neovascular AMD. Neovascular age-related macular degeneration (exudative or wet AMD) is a prevalent, progressive retinal degenerative macular disease that is characterized by. When you get this treatment, your doctor will: Put numbing medicine in your eye. Age-related macular degeneration (AMD) affects an estimated 14 million people worldwide, and is the leading cause of severe, irreversible vision loss in individuals over the age of 50 years in Western societies. Contact Information. ICD-10-CM Diagnosis Codes that Support Coverage Criteria ICD-10-CM Code Description H35. Purpose To describe the clinical and multimodal imaging (MMI) features of age-related macular degeneration (AMD) eyes presenting with intraretinal exudation and no evidence of neovascularization or structural alterations of native retinal vessels. This section shows you chapter-specific coding guidelines to increase your understanding and correct usage of the target ICD-10-CM Volume 1 code. 50 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Advanced Stage. 21 became effective on October 1, 2023. 1. 6 Due to the aging population, this estimate is expected to reach 5. INTRODUCTION. 32 Exudative age-related macular degeneration Wet age-related macular. 219 - other international versions of ICD-10 H26. [2] Around 30% of these patients also develop myopic CNVM in the fellow eye as well. 1 PCNMs account for 10% of all choroidal neovascular membranes with a female predilection. 7% of all global blindness, with the proportion of late-stage AMD being 0. ICD-10 codes not covered for indications listed in the CPB: H35. 3210: 362. 3290 may differ. Another major application for thermal laser photocoagulation is the treatment of extrafoveal choroidal neovascular membranes that occur in AMD. 05 became effective on October 1, 2023. 323 became effective on October 1, 2023. This is the American ICD-10-CM version of H40. 3223 is applicable to adult patients aged 15 - 124 years inclusive. The prevalence of GA goes up with age and it is slightly less than that of neovascular AMD. 32, again without specifying which eye. Sudden-onset of blurring or distortion of vision is often the presenting symptom in the neovascular form. Etiology is unidentifiable in a significant proportion, hence termed as idiopathic. 5 mg ranibizumab compared with 1. ICD-10-CM Diagnosis Codes that Support Coverage Criteria ICD-10-CM Code Description H35. 30 - other international versions of ICD-10 D31. H02. Blurred. This is the American ICD-10-CM version of H35. 61 became effective on October 1, 2023. In the second year of Studies AMD-1 and AMD-2, the ATE rate was 2. 9 became effective on October 1, 2023. 311-E08. 31xx), and wet AMD (H35. Key Points. 21), and waist to height ratio (HR per 0. 3233 is applicable to adult patients aged 15 - 124 years inclusive. Methods: A literature review of anatomical measures of disease activity was conducted. ICD-10 codes covered if selection criteria are met: H35. H35. -) New blood vessels originating from the corneal veins and extending from the limbus into the adjacent corneal stroma. brookss. doi: 10. 1 About 10% of patients with dry AMD will develop subretinal or choroidal neovascular. The 2024 edition of ICD-10-CM H35. Nonexudative AMD Nonexudative (dry or atrophic) AMD accounts for 90 percent of all patients with AMD in the United States. brookss. B. 1X9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 The disorder results from a gradual breakdown of the retinal pigment epithelium (RPE), theRegarding neovascular AMD, a reduction in choriocapillaris blood flow has also been reported . 3211 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 M31. This review aims to provide a comprehensive guide to the pathophysiology, clinical and imaging characteristics, natural course and treatment of the. H02. 90 became effective on October 1, 2023. Our deep. Introduction. Age-related macular degeneration (AMD) is one of the most common causes of vision loss. Short description: Exudative age-rel mclr degn, bilateral, with inactive scar The 2024 edition of ICD-10-CM H35. Neovascular glaucoma (NVG) is a potentially blinding, intractable and aggressive secondary angle-closure glaucoma that is defined by intraocular neovascularization (NV) of the iris and/or anterior chamber angle with increased intraocular pressure (IOP), which leads to devastating visual consequences that complicate a. glaucoma of right eye; Aphakic glaucoma, both eyes; Bilateral glaucoma assoc w other anterior segment anomaly;. Q. 3220 is applicable to adult patients aged 15 - 124 years inclusive. Scar. 212 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. All AMD starts as the dry form, which may progress from early to intermediate and advanced stages, the last of which is called geographic atrophy. 1). 051 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Exdtve age-rel mclr degn, right eye, with inact chrdl neovas The 2024 edition of ICD-10-CM H35. This is the American ICD-10-CM version of H34. 31 Nonexudative age-related macular degeneration;. Intravitreal bevacizumab was injected into OS, and at. In contrast, AMD-associated CNV lesions are typ­ically larger, are often associated with hemorrhage and drusen, and may be accompanied by sub-RPE fluid. H35. 1% (5 of 441) in patients from the control arms. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024. 1X9 became effective on October 1, 2023. With your eye health, neovascularization can be a sign of disease or certain eye conditions. itreal injections of anti–vascular endothelial growth factor agents. 2 letters with monthly dosing. 2016;30:1462–8. ICD-10 code H35. The 2024 edition of ICD-10-CM H16. This is the American ICD-10-CM version of H44. 16 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 362. 4%. 4 million by 2050. Neovascularization refers to the growth of new blood vessels. The second, usually bilateral, is more commonly confused with wet AMD. Tatsuro Ishibashi, in Retina (Fifth Edition), 2013. 1 The severity of hemorrhage with wet. H35. Short description: Exdtve age-rel mclr degn, left eye, with actv chrdl neovas The 2024 edition of ICD-10-CM H35. 329 - other international versions of ICD-10 E11. Upon examination, her visual acuity decreased to 20/40 in the right eye (OD) and 20/50 in the left eye (OS). Moreover, 82 of 91 eyes (90. The following are the ICD-10 diagnostic codes for various forms of AMD: AMD (ICD 10 macular degeneration) Coding for Laterality You must use the sixth character to indicate laterality when using ICD 10 codes for macular degeneration, dry AMD (H35. To address the concern about diagnostic. 1,2,11 The Beaver Dam Eye Study examined the incidence of disease in a cohort of patients aged. 30 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 3231 for Exudative age-related macular degeneration, bilateral, with active choroidal neovascularization is a medical classification as listed by WHO under the. ICD-10-CM Coding Rules. This is the American ICD-10-CM version of H21. The diagnostic imaging tests. Although only 15% of patients with AMD have the wet form, 80 to 90% of the severe vision loss caused by AMD results from. 3 - with inactive scar. The 2024 edition of ICD-10-CM H35. 0): 124 Other disorders of the eye with mcc or thrombolytic agent. Fluorescein angiography (FA) has long been the criterion standard for. H00-H59. 059: Retinal neovascularization, unspecified [associated with age-related macular degeneration] H35. H35. , aflibercept,. 1 became effective on October 1, 2023. 4 may differ. Thread Link: Neovascular ARMD icd 10. Sudden-onset of blurring or distortion of vision is often the presenting symptom in the neovascular form. Age-related macular degeneration (AMD) is one of the most common causes of vision loss. 3131 - other international versions of ICD-10 H35. 89 to ICD-9-CM. 7%. The ATE rate in the three controlled neovascular AMD studies (AMD-1, AMD-2, AMD-3) during the first year was 1. ICD 10 code for Exudative age-related macular degeneration, unspecified eye, with active choroidal neovascularization. The. 5 kg/m 2 1. This is the American ICD-10-CM version of H26. 051 may differ. INTERMEDIATE AMD DEFINED. 403 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 29 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 Even after 10 years, one study found that only 15% of people with no drusen or small drusen at. Cystoid macular degeneration, unspecified eye. Age-related macular degeneration (ARMD) is the most common cause of blindness prevalent in developed countries, particularly in people older than 60 years. 3233 became effective on October 1, 2023. 3111, H35. 1 Definitions Manual: Skip to content: MDC 02 Diseases and disorders of the eye: Assignment of Diagnosis Codes: Page 6 of 8: A1850 E133521 H04141 H15821 H21322 H35019 H4063X0 H53031: H35019: Changes in retinal vascular appearance, unspecified eye: H35021: Exudative retinopathy, right eye:Cataract with neovascularization, left eye. 81% having the atrophic form in at least one eye, but increases to 3. ; Right glaucoma due to vascular disorder; Right mixed mechanism glaucoma; Right neovascular glaucoma. 873 may differ. Early Stage. Kokame. H35. 014, exponential model). 311 may differ. Moved Permanently. nAMD most often starts in one eye, with 18–24% of at-risk, fellow eyes going on to develop the condition within two years [3,3,4,5,6,7,8]. The 2024 edition of ICD-10-CM E11. Definitions for atrophy in the context of neovascular AMD were developed because these lesions are common. It is estimated that 6. In dry AMD. Currently, the approved anti-VEGF drugs. Choroidal neovascularization (CNV) is part of the spectrum of exudative age-related macular degeneration (AMD) that consists of an abnormal growth of vessels from the choroidal vasculature to the neurosensory retina through the Bruch's membrane. Approximately 10-15% of the cases of macular degeneration are the “wet” (exudative) type. Introduction. We illustrate a case of neMNV using OCTA ( Figure 2). Kyoko Ohno-Matsui,. Patients receiving SYFOVRE should be monitored for signs of neovascular AMD. H21. A total of 156,327 patients (185,138 eyes) with a new diagnosis of neovascular AMD who were treated with anti-VEGF therapy from 2013 through 2015 and followed through 2019 were included. H35. Dietary supplements for AMD are widely discussed in the literature. Submacular hemorrhage is a devastating complication of wet age-related macular degeneration (AMD). by 2050. Jul 10, 2018. In conclusion, eyes manifesting neovascular activity by sub-retinal fluid only in a treat & extend anti-VEGF regimen for neovascular AMD seem to exhibit rather low rates of long-term atrophy and. These blood vessels grow in an area called the choroid.