Free CCDS-O Practice Test Questions 2026

Explanation:
The CMS-Hierarchical Condition Category (CMS-HCC) model is a risk adjustment tool used to calculate capitated payments for Medicare Advantage plans. It adjusts payments based on the health status and expected costs of enrollees, ensuring plans are compensated fairly for sicker populations .

Correct Option:

C. determine capitation payments to insurers that administer Medicare Advantage health plans.
This is correct. The CMS-HCC model is specifically designed to adjust the monthly capitated payments made by CMS to private insurers offering Medicare Advantage plans . The model produces a risk score to predict an individual's relative medical expenditures, ensuring payment reflects patient health status .

Incorrect Option:

A. reimburse physicians based on the principal diagnosis.
This is incorrect because the CMS-HCC model is not used for direct physician reimbursement. It is a payment adjustment model for health plans, not a fee-for-service reimbursement system for providers.

B. distribute reimbursement to providers based on quality of care.
This is incorrect. Quality of care is linked to the Medicare Advantage Star Ratings system, which can provide bonus payments, whereas the CMS-HCC model focuses solely on risk adjustment based on patient health status .

D. adjust capitation payments to physicians, excluding advanced practice providers.
This is incorrect. The model applies to health plans, not directly to individual physicians. Furthermore, the model uses diagnoses from various provider types, including non-physician practitioners .

Reference:
CMS.gov documentation: "Medicare Advantage Program Payment System" , CMS "about the principles of risk adjustment" transcript , and CMS "CPC+ Methodology" document .

Explanation:
The patient has a BMI of 45 (severe obesity) and uses CPAP at night, indicating obstructive sleep apnea (OSA). This combination strongly suggests obesity hypoventilation syndrome (OHS) , also known as Pickwickian syndrome, which is characterized by alveolar hypoventilation, daytime hypercapnia, and hypoxia in obese individuals.

Correct Option:

C. Alveolar hypoventilation
This is correct. OHS is defined by the triad of obesity (BMI ≥30), daytime hypoventilation (PaCO₂ >45 mmHg), and sleep-disordered breathing. The CPAP dependence indicates OSA, and the chronic hypoventilation leads to alveolar hypoventilation, making this the direct and expected condition.

Incorrect Options:

A. Heart failure
This is incorrect. While obesity and OSA increase cardiovascular risk, heart failure is not a direct or obligatory consequence of this clinical presentation. The symptoms described (obesity + CPAP) point primarily to a respiratory, not a cardiac, condition.

B. Essential hypertension
This is incorrect. Although hypertension is highly comorbid with obesity and OSA, it is not the specific condition predicted by the combination of severe obesity and CPAP dependence. The question asks for the most likely condition, which is alveolar hypoventilation.

D. Pulmonary edema
This is incorrect. Pulmonary edema is typically caused by left-sided heart failure or acute lung injury. There is no evidence of cardiac decompensation or fluid overload in this scenario, making it unlikely compared to alveolar hypoventilation.

Reference:
American Thoracic Society guidelines on Obesity Hypoventilation Syndrome; UpToDate: "Clinical manifestations and diagnosis of obesity hypoventilation syndrome" ; ICD-10-CM Official Guidelines for coding obesity-related respiratory conditions.

Explanation:
Copying and pasting (cloning) clinical information from a prior inpatient problem list into an ambulatory visit note creates significant documentation integrity issues. It can introduce outdated, irrelevant, or inaccurate diagnoses into the current record. The CDI specialist's role is to support accurate documentation and provider education, not to independently determine diagnosis relevance or query for every listed condition.

Correct Option:

C. Educate the provider regarding the concerns with copying and pasting this list.
This is correct. Provider education is the most appropriate initial action. The CDI specialist should discuss the risks of cloned documentation, including patient safety, billing inaccuracies, and compliance issues. Education promotes sustainable improvement, addresses the root cause, and aligns with the CDI role of supporting providers in maintaining accurate, current, and patient-specific documentation.

Incorrect Options:

A. Do not code conditions that were pasted from the problem list.
This is incorrect. CDI specialists are not coders and should not independently make coding decisions based solely on documentation cloning. Without clinical validation, assuming a condition is invalid is outside the CDI scope and could lead to underreporting of legitimate diagnoses. The focus should be on clarifying documentation, not preemptively excluding codes.

B. Query the provider for each of the conditions on the problem list.
This is incorrect. While queries are appropriate for clarifying ambiguous or conflicting documentation, querying for every condition on a pasted list is inefficient, burdensome, and unnecessary. It places an undue workload on the provider and does not address the underlying documentation behavior. Education is the more strategic and effective approach.

D. Assume the conditions are all relevant for this visit.
This is incorrect. Assuming relevance of pasted diagnoses from a previous inpatient stay is clinically and compliance-risky. Many conditions may have resolved, changed, or may not be pertinent to the current outpatient encounter. This assumption can lead to inaccurate risk adjustment, upcoding, and false medical necessity documentation.

Reference:

ACDIS/AHIMA "Guidelines for Achieving a Compliant Query Practice" (2022 Update) – Section on inappropriate copy/paste and query ethics.

CMS "Medicare Learning Network" – Guidance on medical record documentation integrity and cloned documentation risks.

AAPC "CDI in the Outpatient Setting" – Best practices for provider education and documentation improvement.

Explanation:
Atrial fibrillation (AFib) is classified based on duration and response to treatment. The presence of AFib for 10 days places it in the persistent category, as it exceeds 7 days but is less than 12 months. The discussion of ablation and use of rhythm-control agents (sotalol, atenolol) further supports this classification.

Correct Option:

B. Persistent
This is correct. Persistent AFib is defined as continuous AFib lasting longer than 7 days but less than 12 months. At 10 days, this scenario fits precisely. The planned use of rhythm-control medications and consideration of ablation indicate an intention to restore sinus rhythm, which is consistent with managing persistent AFib.

Incorrect Options:

A. Paroxysmal
This is incorrect. Paroxysmal AFib is defined as episodes lasting less than 7 days (usually ≤48 hours) that terminate spontaneously or with intervention within that timeframe. Since the AFib has been present for 10 days, it exceeds the paroxysmal threshold and no longer qualifies.

C. Chronic
This is incorrect. In the context of AFib classification (especially in ICD-10 and AHA/ACC guidelines), "chronic" is not a distinct category. The AHA/ACC uses long-standing persistent for AFib lasting >12 months. Since this is only 10 days, it does not meet that threshold.

D. Permanent
This is incorrect. Permanent AFib is defined as AFib that is accepted by the patient and physician and no further attempts at rhythm control are made. Here, ablation and rhythm-control drugs are being discussed, indicating active efforts to restore normal rhythm, so it is not permanent.

Reference:

AHA/ACC/HRS 2019 Guideline for the Management of Patients With Atrial Fibrillation – Section on AFib classification (duration-based definitions).

ICD-10-CM Official Guidelines for Coding and Reporting – Chapter 9 (Diseases of the Circulatory System), I48 classification for atrial fibrillation subtypes.

Explanation:
Outpatient encounters are those where the patient is not formally admitted as an inpatient. Observation status and outpatient surgery are classic outpatient settings. However, a scheduled ambulatory surgery is typically billed as an outpatient encounter, but the question likely refers to the place of service or status classification. Under Medicare, an ED visit leading to observation is considered an outpatient encounter. The key distinction is whether the patient is admitted as an inpatient or remains in observation/outpatient status.

Correct Option:

B. ED visit that leads to observation stay
This is correct. An ED visit that results in a patient being placed in observation status is still considered an outpatient encounter. Observation is an outpatient service, and the claim is submitted with an outpatient type of bill. The patient has not been formally admitted as an inpatient, so this remains an outpatient encounter.

Incorrect Options:

A. ED visit that leads to inpatient admission
This is incorrect. Once the ED visit leads to an inpatient admission, the encounter is classified as an inpatient stay. The ED services are often bundled into the inpatient admission under Medicare, and the claim is submitted as an inpatient type of bill, not outpatient.

C. Ambulatory surgery encounter for scheduled sigmoid resection
While ambulatory surgery is generally an outpatient service, this specific option is considered incorrect in this context because the question likely focuses on the type of bill and status. Sigmoid resection is a major procedure; if performed in a hospital outpatient department, it is still outpatient. However, if the intent of the question is to test Medicare's "inpatient only" or "2-midnight" rule, this may be an outpatient procedure if performed in an ASC or outpatient setting—but the better answer is B because observation is explicitly an outpatient status.

D. Admission for COPD exacerbation with length of stay less than two midnights
This is incorrect. Under Medicare's 2-midnight rule, a stay that does not cross two midnights is generally presumed inappropriate for inpatient admission and should be billed as observation (outpatient). However, if the physician admits the patient as an inpatient and the stay is less than two midnights, it may still be billed as inpatient if medically necessary and properly documented. The encounter itself is considered an inpatient admission; the billing status depends on the admission order, not the length of stay. Therefore, it is not automatically an outpatient encounter.

Reference:

CMS Medicare Claims Processing Manual, Chapter 4 – "Part B Hospital (Including Inpatient Hospital Part B and OPPS)" – Definition of outpatient and observation services.

CMS IOM Publication 100-04, Chapter 3, Section 40 – "Outpatient Prospective Payment System (OPPS)" – Clarifies observation as an outpatient service.

2-Midnight Rule guidance from CMS – Distinction between inpatient admission and outpatient observation.

Explanation:
The scenario describes a patient with colon cancer, lung metastasis, and chemotherapy, presenting with UTI and elevated creatinine. The labs reveal pancytopenia (anemia, leukopenia, thrombocytopenia). The key query opportunity lies in linking the pancytopenia to the chemotherapy, as this creates a disease-drug interaction that impacts risk adjustment by capturing a more specific, higher-weighted diagnosis.

Correct Option:

D. Chemotherapy induced pancytopenia
This is correct. The lab values (hemoglobin 7.9, WBC 2,500, platelets 20,000) clearly indicate pancytopenia. The patient is actively receiving chemotherapy, which is a known cause of bone marrow suppression. Querying to confirm chemotherapy-induced pancytopenia captures a clinically significant, drug-induced condition that increases the risk score and accurately reflects the patient's severity of illness.

Incorrect Options:

A. Colon cancer and lung metastasis
This is incorrect. The documentation already states "newly diagnosed lung metastasis," so the relationship between colon cancer and metastasis is already established. No query is needed to link these, and this combination does not represent a new disease interaction that impacts risk adjustment beyond what is already documented.

B. Colon cancer and chemotherapy
This is incorrect. The documentation already indicates the patient is receiving chemotherapy for colon cancer. This is a straightforward treatment relationship and does not represent an ambiguous or undocumented interaction. Querying for this would not add new risk-adjustment value.

C. Acute tubular necrosis and UTI
This is incorrect. While the patient has a UTI and elevated creatinine, the documentation does not support ATN as a diagnosis. ATN is a specific form of acute kidney injury, and there is no mention of hypotension, nephrotoxic agents, or other ATN precursors. Querying for ATN would be unsupported and speculative without clinical indicators.

Reference:

CMS-HCC Risk Adjustment Model – Hierarchical condition categories prioritize specific, high-impact diagnoses like drug-induced pancytopenia.

ICD-10-CM Official Guidelines – Section I.C.2.e – Chemotherapy-induced pancytopenia (D61.810) is coded when documented by the provider.

ACDIS/AHIMA "Guidelines for Achieving a Compliant Query Practice" – Queries should address clinically significant, undocumented, or ambiguous conditions that impact severity, mortality, or risk adjustment.

Explanation:
A compliant query is a communication tool used to clarify ambiguous, conflicting, or incomplete documentation. It must remain neutral and objective, presenting only the clinical facts without suggesting a specific diagnosis. This ensures the provider's clinical judgment drives the final documentation, maintaining integrity and avoiding allegations of upcoding or pressure.

Correct Option:

B. Be non-leading and include clinical indicators
This is correct. A compliant query must present pertinent clinical indicators (e.g., labs, vital signs, imaging findings) factually, without directing the provider toward a specific answer. It must be non-leading, allowing the provider to use their expertise to reach a diagnosis. This approach complies with AHIMA/ACDIS guidelines and supports ethical, accurate documentation.

Incorrect Options:

A. Lead the provider to a specific diagnosis
This is incorrect. Leading the provider toward a specific diagnosis is considered non-compliant and unethical. It can introduce bias, compromise clinical judgment, and potentially result in inappropriate coding or overdocumentation. Queries must remain neutral and allow providers to draw their own conclusions based on clinical evidence.

C. Be verbal only
This is incorrect. While verbal queries can be used in certain situations (e.g., concurrent CDI), they are not the only acceptable format. Written queries (electronic or paper) are actually preferred because they create a clear, auditable trail of communication. A compliant query can be verbal or written, but written is recommended for documentation integrity and compliance purposes.

D. Be open-ended without context
This is incorrect. An open-ended query with no clinical context is ineffective and non-compliant because it does not provide the provider with the necessary clinical picture to make an informed decision. A compliant query should include relevant clinical indicators and a clear question, while remaining non-leading and allowing the provider to document their clinical reasoning.

Reference:

AHIMA/ACDIS "Guidelines for Achieving a Compliant Query Practice" (2022 Update) – Sections on query neutrality, clinical indicators, and written vs. verbal queries.

CMS "Medicare Learning Network" – Guidance on documentation integrity and compliant query practices.

OIG Work Plan – Emphasis on avoiding leading queries that could result in upcoding or fraudulent billing.

Explanation:
The scenario describes a patient with severe COPD (GOLD stage 3) and recent pneumonia, now presenting with increased shortness of breath, escalated home oxygen, home nebulizers, and systemic steroids (Solu-Medrol). The most significant query opportunity is to clarify whether chronic respiratory failure is present, as this condition has a major impact on severity of illness, risk of mortality, and risk adjustment, and is often underdocumented in outpatient settings.

Correct Option:

C. Presence of chronic respiratory failure
This is correct. The patient has advanced COPD, worsening dyspnea, increased oxygen requirements, and requires nebulizers and steroids—all clinical indicators that strongly suggest chronic respiratory failure may be present. Querying for this diagnosis, if supported by documentation (e.g., ABG findings, PaCO₂ >45, hypoxemia), captures a high-risk, high-impact condition for risk adjustment and accurately reflects the patient's clinical complexity.

Incorrect Options:

A. Specificity of the organism causing the pneumonia
This is incorrect. The patient had a recent inpatient admission for pneumonia, but the current visit is for follow-up and management of COPD exacerbation. Specifying the organism is not clinically relevant to the current encounter's primary management, nor does it significantly impact risk adjustment compared to capturing chronic respiratory failure.

B. Acuity of the COPD
This is incorrect. While determining whether the COPD is acute, chronic, or exacerbated is important, the documentation already indicates "COPD - GOLD stage 3," which suggests a chronic baseline. Querying for "acute exacerbation" may be relevant, but it does not carry the same severity, mortality, and risk-adjustment weight as chronic respiratory failure in this clinical context.

D. Oxygen dependence
This is incorrect. Oxygen dependence (Z99.81) is a supplementary factor that can be coded if documented, but it does not significantly impact risk adjustment compared to chronic respiratory failure. It describes a supportive therapy rather than a disease state, and querying for this would not add substantial clinical or financial value in this scenario.

Reference:

CMS-HCC Risk Adjustment Model – Chronic respiratory failure (J96.1-) is a high-hierarchical condition category with significant risk score weight.

ICD-10-CM Official Guidelines – Section I.C.10.a – Respiratory failure codes require provider documentation of the condition.

ACDIS/AHIMA "Guidelines for Achieving a Compliant Query Practice" – Queries should focus on clinically significant conditions that impact severity, mortality, and risk adjustment.

GOLD Report 2023 – COPD management and respiratory failure criteria.

Explanation:
This encounter involves a patient with multiple chronic conditions and a medication-related adverse effect. The provider explicitly documents that the cough is an adverse effect of the ACE inhibitor (Enalapril) and discontinues it. All documented conditions that are relevant, co-managed, or impact patient care during this visit should be reported to accurately reflect the patient's clinical picture and risk adjustment.

Correct Option:

D. Cough; adverse effect of an ACE inhibitor; COPD, unspecified; asthma, unspecified, uncomplicated; hypertension

This is correct. Coding guidelines require reporting:

Cough (R05) as the presenting symptom.

Adverse effect of ACE inhibitor (T46.4X5A) with the drug code to capture the medication-induced cause.

COPD (J44.9) and asthma (J45.909) as they are chronic conditions being actively managed (medications continued).

Hypertension (I10) as it is being treated and the medication change directly relates to its management. All are documented and clinically relevant to this encounter.

Incorrect Options:

A. COPD, unspecified; asthma, unspecified, uncomplicated; hypertension
This is incorrect because it omits the cough and the adverse effect of the ACE inhibitor, which are the primary reasons for this visit and the therapeutic intervention (discontinuing Enalapril). Failure to capture the adverse effect misses the key clinical event and drug-disease interaction.

B. Cough; adverse effect of an ACE inhibitor; COPD, unspecified; hypertension
This is incorrect because it omits asthma, which is documented as a chronic condition with active management (medications continued). Per ICD-10 guidelines, all chronic conditions that are treated, monitored, or otherwise addressed during the encounter should be coded.

C. COPD, unspecified; hypertension
This is incorrect because it omits the cough (the presenting symptom), the adverse effect of the ACE inhibitor (the causal relationship), and asthma (a documented chronic condition with continued management). This option severely underreports the clinical complexity of the encounter.

Reference:

ICD-10-CM Official Guidelines for Coding and Reporting – Section I.B.8 (Coding for adverse effects and poisoning) – For adverse effects, code the nature of the adverse effect (e.g., cough) first, followed by the appropriate adverse effect code (T46.4X5A) and the drug code.

ICD-10-CM Guidelines – Section I.C.9 (Hypertension), I.C.10 (COPD/asthma) – Chronic conditions managed or addressed should be coded.

ACDIS/AHIMA Query Guidelines – All clinically significant conditions documented should be captured.

ICD-10-CM Official Guidelines – Section I.B.2 – "All documented conditions that coexist at the time of the encounter and require or affect patient care, treatment, or management should be coded."

Explanation:
The RAF (Risk Adjustment Factor) score is a core concept in value-based care models like Medicare Advantage. It is calculated from the patient's documented diagnoses to predict their future healthcare costs. The most appropriate response to a provider questioning its impact on patient care is to frame the RAF score as a tool for predicting the resources needed to manage the patient's health.

Correct Option:

B. “It predicts expected resources needed to care for the patient.”
This is correct. This response directly connects the RAF score to patient care and resource allocation. It explains that a higher RAF score (indicating sicker patients) helps the healthcare system anticipate the need for more intensive management, specialists, and treatments. This frames risk adjustment as a tool to ensure adequate resources are available for complex patients, which directly impacts the quality and planning of their care.

Incorrect Options:

A. “It determines what you will be reimbursed.”
This is incorrect because while RAF scores do influence plan reimbursement, this response focuses on financial compensation to the provider. It does not address the provider's concern about patient care and may make the CDI process appear purely revenue-driven, which can damage provider engagement.

C. “It determines the patient’s out of pocket expenses.”
This is incorrect. The RAF score has no direct impact on a patient's out-of-pocket costs (like copays, deductibles, or premiums). Those are determined by the specific insurance plan benefits and do not fluctuate based on the patient's RAF score.

D. “It predicts medical necessity of ordered procedures/treatments.”
This is incorrect. Medical necessity is determined by clinical guidelines and the patient's presenting signs/symptoms, not by the RAF score. The RAF score predicts overall cost and resource utilization, but it does not justify or predict the necessity of specific procedures or treatments.

Reference:

CMS-HCC Risk Adjustment Model documentation – RAF scores are used to predict annual healthcare expenditures for Medicare beneficiaries.

Centers for Medicare & Medicaid Services (CMS) – "Risk Adjustment" overview: The model predicts costs to ensure plans are paid appropriately for the health status of their enrollees.

ACDIS/AHIMA CDI best practices – Emphasizes framing risk adjustment discussions around patient care and resource utilization to improve provider engagement and documentation accuracy.

Explanation:
This scenario involves a patient with Type 2 Diabetes and documented vascular conditions. ICD-10-CM coding guidelines require that when diabetes is associated with a circulatory condition, it is coded as diabetes with peripheral angiopathy. Additionally, both the atherosclerosis and hypertension are separately documented and should be coded to accurately capture the full clinical picture.

Correct Option:

C. Diabetes with peripheral angiopathy, atherosclerosis bilateral legs, hypertension
This is correct. The provider documents "Type 2 Diabetes with bilateral peripheral arteriosclerotic disease," which maps to E11.51 (Type 2 diabetes with peripheral angiopathy without gangrene) . The atherosclerosis of the bilateral lower extremities is coded separately as I70.203 (Unspecified atherosclerosis of native arteries of extremities, bilateral legs) , and hypertension (I10) is also documented. All conditions are separately reportable when documented.

Incorrect Options:

A. Diabetes without complications, atherosclerosis bilateral legs
This is incorrect. The documentation specifically links the diabetes to the peripheral arteriosclerotic disease ("Type 2 Diabetes with bilateral peripheral arteriosclerotic disease"), so coding diabetes without complications (E11.9) would miss the known complication and underreport the patient's clinical severity.

B. Diabetes with peripheral angiopathy, hypertension
This is incorrect because it omits the atherosclerosis of the bilateral legs, which is a separately documented vascular condition with its own specific ICD-10 code (I70.203). All documented conditions should be coded, and omitting this misses a significant comorbidity.

D. Diabetes with peripheral angiopathy, atherosclerosis bilateral legs, diabetes with circulatory complication, hypertension
This is incorrect because it double-codes the diabetic complication. "Diabetes with peripheral angiopathy" already captures the circulatory complication of diabetes. Adding "diabetes with circulatory complication" as a separate code is redundant and not supported by ICD-10 guidelines, which prohibit coding the same manifestation twice.

Reference:

ICD-10-CM Official Guidelines for Coding and Reporting – Section I.C.4.a – "Diabetes mellitus and the use of insulin and oral hypoglycemics" – Codes for diabetes with complications are assigned when the provider documents a manifestation.

ICD-10-CM Guidelines – Section I.C.4.a.3 – "Diabetes mellitus with peripheral angiopathy" (E11.51) is coded when peripheral vascular disease is documented as a diabetic complication.

ICD-10-CM Guidelines – Section I.B.4 – "Code all documented conditions that coexist at the time of the encounter and require or affect patient care, treatment, or management."

ICD-10-CM Official Guidelines – Chapter 9 (I70) – Atherosclerosis coding requires specificity for site and laterality.

ICD-10-CM guidelines prohibit coding the same condition twice under different codes (e.g., coding both E11.51 and a separate "diabetes with circulatory complication").

Explanation:
The problem list is a critical component of the electronic health record (EHR) that serves as a centralized, up-to-date summary of a patient's active and significant diagnoses, allergies, and procedures. Its primary purpose is to ensure care coordination, clinical decision-making, and patient safety across all care settings and encounters.

Correct Option:

B. A well-maintained problem list is vital in the continuity of patient care.
This is correct. A current, accurate problem list allows all providers involved in a patient's care (primary care, specialists, hospitalists, etc.) to quickly understand the patient's complete clinical picture. It prevents unnecessary duplication of tests, avoids adverse drug interactions, ensures timely preventive care, and supports safe transitions of care—all of which are essential for continuous, high-quality patient management.

Incorrect Options:

A. Problem list diagnoses should be removed after one year.
This is incorrect. Diagnoses should not be removed based on a time limit like one year. A diagnosis should be removed only when it is resolved, no longer active, or deemed clinically irrelevant by the provider. Chronic, lifelong conditions (e.g., diabetes, COPD) remain on the problem list indefinitely unless the provider specifically documents resolution.

C. More diagnoses on the problem list assist the provider in caring for the patient.
This is incorrect. Having more diagnoses does not equate to better care. In fact, an overpopulated, poorly maintained problem list with resolved, outdated, or unconfirmed conditions can cause confusion, lead to unnecessary testing or treatments, and increase the risk of medical errors. The problem list should contain only active, relevant, and confirmed diagnoses.

D. A CDI specialist should update the problem list to provide continuity of care.
This is incorrect. While CDI specialists may identify documentation gaps and recommend additions, only the treating provider has the clinical authority and accountability to add, remove, or modify diagnoses on the problem list. CDI specialists support accurate documentation but do not independently update the problem list.

Reference:

CMS Conditions of Participation (CoP) for Medical Records – §482.24(c) – Requires a problem list as part of the medical record to ensure continuity of care.

Joint Commission Standard IM.04.01.01 – Requires organizations to maintain a complete and accurate problem list.

ACDIS/AHIMA "CDI and the Outpatient Setting" – Emphasizes provider ownership of the problem list and CDI's role in supporting accurate documentation.

AHIMA "Managing the Problem List" – Best practices state that problem lists should be updated at each encounter and diagnoses removed only when resolved, not on an arbitrary time basis.