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For more solutions, check out our guide to troubleshooting Autodesk product download issues. Students and educators can get free one-year educational access to Autodesk products and services, which is renewable as long as you remain eligible. When buying your subscription, enter the same email address and password combination you used to sign into your trial.

Learn more about converting a trial to a paid subscription. All rights reserved. Download free trial of AutoCAD Download free trial. What is AutoCAD? Design and annotate 2D geometry and 3D models with solids, surfaces, and mesh objects. Create a customized workspace to maximize productivity with add-on apps and APIs. Explore AutoCAD. Visit Autodesk app store. Read story. Frequently asked questions FAQs. What is AutoCAD used for? Who uses AutoCAD? How much does an AutoCAD subscription cost?

See more. See less. Support and learning. Get AutoCAD documentation, tutorials, downloads, and support. When great minds have great tools they can accomplish great things.

AEC Collection includes:. Explore the AEC Collection. What you can do with the collection. Workflows from design to construction. Integrated workflows from design to construction in the AEC Collection video: min.

Learn more about the AEC Collection. Learn more about AutoCAD. Discover the new features of AutoCAD with on-screen demonstrations. Watch video min. AutoCAD vs. Learn about different time-saving features in AutoCAD, from trainings to automation. Design and create with AutoCAD. Compare related products. Download Email In most cases, if you downloaded your product, you received an email containing the serial number and product key. Autodesk eStore If you ordered your product from the online Autodesk store, the serial number and product key are in the Fulfillment Notification email.

Expand the product details to find your serial number and product key. Autodesk Account: Contract Details Report If you are a Software Coordinator or Contract Manager, your contract details report lists serial numbers and product keys for all products on your subscription contract. Log in to your Autodesk Account and click Contracts and Orders from the main menu on the left. Text wrapping feature is also included and now text will be wrapped automatically in the dimension fields.

There is a new Modify option included which will let you draw new revision cloud segment. The interface for AutoCAD is very intuitive and is helpful for all the users to access all the tools easily. The New Tab drawing file tab has been renamed as Start. AutoCAD has got a comprehensive Help file which will guide you at each and every step. Developers: AutoCAD. This is complete offline installer and standalone setup for AutoCAD This post will continue to be updated and the latest edits should follow IGGTech.

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Autodesk autocad 2016 64 bit serial number free. All AutoCAD Versions Serial Number and Product key

I am having autocad 64bit version and downloaded from internet and after downloading i had seen that it was a trial version,now what should i do to make it full version. Copyright by Autodesk, Inc. All rights reserved. Go to Solution. Solved by simona. I assume since this is you are a student. All Autodesk software initially installs in day trial mode to give you several weeks to make sure it is running correctly as you can only activate twice.

Did you watch the videos on the student website on how to download, extract, install and activate? If so, what part did you not understand? Start Program 2. Mark Lancaster. Did this resolve your issue? Please accept it "As a Solution" so others may benefit from it.

Please send me the activation code. Thank you First of all.. Don't share personal information here such as your serial. This is world wide public user forum. Granted this is a legacy version and it really doesn't matter but don't share that type of information.

In addition just because you have a serial and request code doesn't mean your software can be activated. Its based on the history of the serial and its still valid. May I ask why you need to activate a legacy, unsupported, retired Autodesk Product?

NET Framework 4. See below online solutions:. NET 4. Please refer to the System Requirements to check which Microsoft. NET is required. Subscription, Installation and Licensing. Previous Version Support. Share your knowledge, ask questions, and explore Previous Version Support topics.

Turn on suggestions. Auto-suggest helps you quickly narrow down your search results by suggesting possible matches as you type. Showing results for. Search instead for. Did you mean:. This page has been translated for your convenience with an automatic translation service. This is not an official translation and may contain errors and inaccurate translations. Autodesk does not warrant, either expressly or implied, the accuracy, reliability or completeness of the information translated by the machine translation service and will not be liable for damages or losses caused by the trust placed in the translation service.

Back to Subscription, Installation and Licensing Category. Back to Topic Listing Previous Next. Message 1 of Tags 2. Message 2 of Either buy it from a authorized reseller or directly from Autodesk. If so please use the Accept as Solution or Kudos button below. Message 3 of Message 4 of Message 5 of Message 6 of Tags 1. Tags: m. Message 7 of Message 8 of Where did you purchase the software.

Message 9 of Message 10 of Do you have an actual issue? Message 11 of Message 12 of Message 13 of Enter reply text. Message 14 of Message 15 of Simona Golisciano. Message 16 of Message 17 of Post Reply.

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Last Updated: September 5, Tested. Luigi has over 25 years of experience in general computer repair, data recovery, virus removal, and upgrades. He is also the host of the Computer Man Show! The wikiHow Tech Team also followed the article's instructions and verified that they work. /8711.txt article has been viewed 4, times.

You may lose some special formatting in the conversion process, but you can always make adjustments in Word. If you have MS Word, right-click the file on your computer, select Open withand then select Word on the menu. Click OK to allow Word to change the display format. Edit the file as needed, click the File menu, and select Save As. Choose a location to save the file, make sure the ""Word Document"" option is selected as the file format, and adobe acrobat x pro pdf in word umwandeln free download click Save.

But, if the PDF contains images, they may be lost during the conversion. In your web browser, navigate to system requirements adobe indesign cs6 free. Click the small folder icon at the top-right corner of the file list, click Uploadselect the PDF, and then click Open to upload it. When the upload adobe acrobat x pro pdf in word umwandeln free download complete, Google Docs will display a preview. Click the Open With menu at the top and select Google Docs.

First, open the PDF file with Acrobat. You can then save the file to the desired location. Did this summary help you? Yes No. Log in Social login does not work in incognito and private browsers. Please log in with your username or email to continue. No account yet? Create an account. Popular Categories. Arts and Entertainment Artwork Books Movies. Relationships Dating Love Relationship Issues. Hobbies and Crafts Crafts Drawing Games. All Categories. Edit this Article. We use cookies to make wikiHow great.

By using our site, you agree to our cookie policy. Cookie Settings. Learn why people trust wikiHow. Download Article Explore this Article methods. Tips and Полезное download multisim for windows 10 статью. Related Articles. Article Summary. Method 1. Right-click the PDF you want to open. If you're using a Mac and don't have a right mouse button, press Control as you click the file.

This will open a context menu. Select Open with. It's near the top of the menu. Another menu will expand. Click Word or Microsoft Word on the menu. This opens Word and attempts to display the PDF.

Click OK to convert the file. Word will convert the file to its own format and display the results. If you're converting a larger file, it can take a few minutes to complete. Edit the Word document.

The converted document may not have perfect page to page correspondence due to line and page breaks, graphics, and по этой ссылке details. Making manual adjustments may be necessary. If you downloaded the PDF from the internet, you'll see a bar at the top of the document asking if you want enable editing.

Click Enable Editing so you can make changes to the file. Save the converted PDF. Once you're ready to save the converted file as its own Word document, do the following: Windows — Click Fileclick Save Asclick This PCenter a file name, select a save location on the left side of the window, and click Save.

Method 2. This will open your Google Docs page if you're logged into your Google Account. If you aren't logged in, enter your email address and password when adobe acrobat x pro pdf in word umwandeln free download. You may first have to click Go to Google Docs in the middle of the page. Click the Upload tab. It's at the top of the "Open a file" window. Click Select a file from your device.

It's the blue button in the center of the window. Select your PDF file and click Open. Click the Open with menu. It's at the top-center part of the window. If you don't see the Open with drop-down box, move your mouse to the top of the window. Click Google Docs on the menu. If you don't see Google Docs as an option in the drop-down menu, you can add it: click Connect more apps in the drop-down menu, search for google docsand Install to get it. Save the PDF as a Word document.

Now that you've opened the document in Docs, you can save it as ошибаетесь. 41d7675 liftmaster manual тяжело Microsoft Word file and download it to your computer. Here's how: Click File in the upper-left side of the Google Docs page. Select Download. Click Microsoft Word. Method 3. All rights reserved.

This image may not be used by other entities without посмотреть еще express written consent of wikiHow, Inc. You'll find this app in your Windows Start menu or your Mac's Applications folder. Right-clicking the file on your computer will open a context menu.

If you're using a Mac and don't have a right mouse button, press Control as you click the file instead. Click Export PDF.

Adobe acrobat x pro pdf in word umwandeln free download tool is in the right panel. A list of file types will expand. Click Microsoft Word as the export format. Additional options will expand. Click Word Document.

It's the first option on the right panel. Click Export. Acrobat will now convert the file and prompt you to name it. Name the file and click Save. Luigi Oppido. You'll have to open the PDF document as a Word file.

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Language in Windows. You'll need to choose the same language when you install Windows Edition of Windows. You should also choose the same edition of Windows.

For more info, go to the Volume Licensing Service Center. Microsoft Office products. If you just purchased a new device that includes Office , we recommend redeeming installing Office before upgrading to Windows For more information, check How to upgrade to Windows 10 on new devices that include Office Using the tool to create installation media: Select Download tool now , and select Run.

If you agree to the license terms, select Accept. Any content on the flash drive will be deleted. ISO file. After the file is downloaded, you can go to location where the file is saved, or select Open DVD burner , and follow the instructions to burn the file to a DVD. After the installation media is created, follow the steps below to use it.

Restart your PC. On the Install Windows page, select your language, time, and keyboard preferences, and then select Next. Select Install Windows. Right-click the ISO file and select Mount. Double-click the ISO file to view the files within. Double-click setup.

Visit the Windows Insider site to download Insider Preview builds. Visit the Download Academic Products page for Education editions product key required. Unified Write Filter UWF An optional function that helps to protect your drives by intercepting and redirecting any writes to the drive to a virtual overlay. Simplified updates Simplify deployment and updates with tools IT pros trust and give them freedom to drive more business value.

Delivery Optimisation Enables peer-to-peer transfer of updates. Windows Update for Business Stay up to date with a simple cloud-based service that integrates with System Centre Configuration Manager. Windows 10 Long Term Service Channel. Desktop Analytics Powerful insights and recommendations about your computers, applications and drivers to monitor deployment progress. Flexible management Apply comprehensive device management on your terms that supports employees working from anywhere.

Mobile Device Management A secure and uniform means of managing devices. Windows Autopilot 7 New devices can easily be set up following a cloud powered pre-configured process.

Microsoft Store for Business 9 To find, acquire, distribute and manage apps for your organisation. Mobile Application Management Employees can use their personal devices to access work apps and content without IT help. Microsoft User Experience Virtualisation UE-V 10 Capture user-customised Windows and application settings and store them on a centrally-managed network. Microsoft Application Virtualisation App-V 10 Enables organisations to deliver Win32 applications to users as virtual applications.

Microsoft Endpoint Manager Unified, integrated management platform for managing all your endpoints. Enhanced productivity Collaborate and work more efficiently with an intuitive user experience and built-in tools and features. Microsoft Edge A fresh approach to the browser, giving you world-class compatibility and performance, control and security from Microsoft, and productivity tools for the web.

Cortana Your personal productivity assistant, now even better. Microsoft apps on Windows Gives individuals and teams the breadth of tools they need to do what matters - faster.

Microsoft Whiteboard A free-form digital canvas where people, ideas and content can come together. OneNote for Windows 10 OneNote for Windows 10 is always up to date with the latest intelligence and productivity features. Work across devices 12 Windows 10 apps designed for mobile devices help users move freely between their phone and PC.

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Requires Windows Server. We recommend that K customers using commercial Windows 10 Enterprise read the document and apply desired settings for your environment. For any other questions, contact Microsoft Customer Service and Support. Windows 10 upgrade paths. Volume Activation for Windows Plan for volume activation.

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Functional Functional Always active The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.

The technical storage or access is necessary for the legitimate purpose of storing preferences not requested by the subscriber or user.

Technical storage or access used exclusively for statistical purposes. Technical storage or access used solely for anonymous statistical purposes. Without subpoena, voluntary compliance by your Internet Service Provider, or additional data from a third party, information stored or retrieved solely for this purpose usually cannot be used to identify you.

The technical storage or access is necessary to create user profiles for sending advertising, or to track the user on a website or across different websites for similar marketing purposes. フィードバックが Microsoft に送信されます。[送信] ボタンを押すと、お客様からのフィードバックが Microsoft 製品とサービスの品質向上のために使用されます。プライバシーポリシー。. Windows 10 IoT は、エンタープライズクラスのパワー、セキュリティ、管理の容易性をモノのインターネットにもたらす Windows 10 ファミリのメンバーです。 Windows に組み込まれたエクスペリエンス、エコシステム、クラウド接続を活用することで、組織は迅速なプロビジョニング、容易な管理、クラウド戦略全体へのシームレスな接続が可能なセキュアデバイスを使ってモノのインターネットを構築できます。.

Windows 10 IoT には 2 つのエディションがあります。 Windows 10 IoT Core は Windows 10 オペレーティングシステムファミリの最小のメンバーです。単一のアプリを実行するだけですが、Windows 10 に期待される管理の容易性とセキュリティを備えています。対照的に Windows 10 IoT Enterprise は、Windows 10 の通常版で、アプリケーションや周辺機器の特定のセットにロックダウンされた専用デバイスを作成するための特別な機能を備えています。. Windows 10 IoT Core と Windows 10 IoT Enterprise は名前が似ていますが、提供するものやサポートするものに違いがあります。以下は、エディションの違いを強調した機能一覧です。. この記事は海外Red Ventures発の記事を朝日インタラクティブが日本向けに編集したものです。. ZDNet Japanは、CIOとITマネージャーを対象に、ビジネス課題の解決とITを活用した新たな価値創造を支援します。 ITビジネス全般については、 CNET Japan をご覧ください。.

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Clear instructions. Very nice unit. I must also say that the tech support was far better than I ever expected. Michelle was not only professional, courteous and knowledgeable, but , she made me feel like a valued customer as well. Rare this days. Kudos to Michelle. The charger reconditions the battery as it charges. It can take up to 24 hours to fully charge the battery. Once the battery is fully charged, the bar will no longer flash.

Once the battery is charged, you can leave the maintainer connected to the battery to keep the battery in a charged state, so it will be ready when you are.

You only need to unplug the unit from the wall before starting your vehicle. You would need to connect the the ring terminal to the bolt that comes out of the connector on your battery, not the battery post itself. The charger has safety features built in. If the charger can not detect that it is connected to a battery, then it will not send a charge through the cables.

Your battery must have at least 3 volts in order to be able to be charged. If the charger can not detect that it is connected to a battery, then it will not send a Voltage through the cables.

Auto shops test your battery for current under load. It will only show if the car will start. Your battery may still need to be charged longer to fully charge the battery. When our 4 amp maintainer shows an error message immediately, it indicates a bad battery or the voltage of the battery is below 4 volts.

Close menu. Close cart. Add to cart. Write a Review. Alan W. Verified Buyer. I recommend this product. Table of Contents. Previous Page. Next Page. Reserve Capacity Follow connection procedure. Ampere-hours Page 2 For technical questions, please call Item Page 3 6. Do not operate charger with damaged cord or plug current high enough to weld a ring or the — replace the cord or plug immediately.

Item For technical questions, please call Page Do not face battery when making final connection. Page 4 For technical questions, please call Page 5 — risk of Fire or Electric Shock. Connect battery charger directly to grounding receptacle three-prong. An adapter should not be used with battery charger.

High frequency current pulse can be used to recondition batteries that are weak, sulfated or deeply drained. Three levels of protection include Overheat, Overcharge and Reverse Polarity. Ive had this one at my house for a year and use it often on the M cars since they mostly sit.

I use it very often. Joined Sep 25, Messages 9, Location Marshfield Fully automatic microprocessor control feature adjusts the amperage rate to charge and maintain batteries quickly and safely with one press of a button. A jump pack — a more conveniently designed portable jump-starting device — is Charging car battery with a 4 Amp battery charger.

John Alexander Berry "B2". The charger includes alligator clamps for periodic charging, as well as ring terminals for semi-permanent battery attachment ideal for maintenance. Item Information: viking 12 volt battery charger. Skip to main content. Shop by category.

Harbor Freights Viking quick charger is actually pretty good. Be careful to not charge at a high Amp rating on a small battery! Yes, all 4 of our Intelligent Battery Chargers are Advanced How old is the battery you're charging, and why does it need to be charged? Enter your search keyword. Advanced: …www. This fully automatic microprocessor controlled battery charger can charge all lead acid 12v batteries including deep-cycle, gel and AGM. Viking Top 10 Jump Starters of The Viking battery tender is a no frills unit with everything The multi-stage charging protocol ensures an optimal charge on all types of 6-Volt or Volt vehicle A battery charger is a great tool to keep in your home or shop.

Viking 4 Amp Battery Charger Manual - Wakelet.

When unpacking, make sure that the product is intact. If any parts are missing or broken. No portion of this manual or any artwork contained herein may be reproduced in.

Diagrams within this manual viking 4 amp battery charger manual not be drawn proportionally. Due to continuing. Tools required for assembly and service may bqttery be included. Keep this manual for the safety warnings and precautions, assembly. Table of Contents. Previous Page. Next Page. Reserve Capacity Follow connection procedure. Ampere-hours Page посетить страницу For technical questions, please call Item Page 3 6.

Do not operate charger with damaged cord or plug current high enough to weld a ring or the — replace the cord or viking 4 amp battery charger manual immediately. Item For technical questions, please call Page Do not face battery when making final connection. Page 4 For technical questions, chargrr call Page 5 — risk of Fire or Electric Shock.

Connect battery charger directly to grounding receptacle three-prong. An adapter should not be used with battery charger.

Page 7 4. Do not operate Charger in a closed-in battery being charged; gases from /10917.txt area or restrict ventilation in viking 4 amp battery charger manual way. Do not set a battery on top of Charger. Page 8 For technical questions, please call Page 9: Operation The charger will then automatically enter maintenance mode.

Page 10 For technical questions, please call Page 11 Serial number Here: note: If product has no serial number, record month and year of purchase instead. Print page 1 Print document 12 pages. Rename the bookmark. Delete bookmark? Cancel Delete. Delete from my manuals? Sign In OR. Don't have an account? Sign up! Restore password. Upload manual. Upload from disk. Upload bsttery URL.

Viking 4 amp battery charger manual

Hide thumbs. Table Of Contents. Quick Links. Write the product's serial number in the. Keep this manual and the receipt in a safe and dry place for future reference. Email our technical support at: productsupport harborfreight. When unpacking, make sure that the product is intact. If any parts are missing or broken,. No portion of this manual or any artwork contained herein may be reproduced in. Diagrams within this manual may not be drawn proportionally.

Due to continuing. Tools required for assembly and service may not be included. Keep this manual for the safety warnings and precautions, assembly,. Read this material before using this product. Failure to do so can result in serious injury. Table of Contents. Previous Page. Next Page. Wear ANSI-approved splash-resistant safety goggles. Ampere-hours Follow connection procedure. Page 2 For technical questions, please call Item Page 3 A lead-acid battery can produce a short- plug — replace the cord or plug immediately.

Item For technical questions, please call Page Do not face battery when making final connection. Page 4 For technical questions, please call Page 5 Improper connection accordance with all local codes and ordinances. Page 6 For technical questions, please call Page 7 4. Do not operate Charger in a closed-in battery being charged; gases from battery area or restrict ventilation in any way.

Do not set a battery on top of Charger. Page 8 For technical questions, please call Page 10 For technical questions, please call Page 11 Disconnect power supply before service. Print page 1 Print document 12 pages. Rename the bookmark. Delete bookmark? Cancel Delete. Delete from my manuals? Sign In OR. Don't have an account? Sign up! Restore password. Upload manual. Upload from disk. Upload from URL.

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Pathology and Laboratory Procedures. Medicine Services and Procedures. Evaluation and Management Services. Last Reviewed on Dec. Call or have a career counselor call you. Resources Toggle Menu. Overview Hot Topics. Get Real-world Coding Experience Improve coding skills across multiple specialties coding actual medical charts Practicode. Looking for Exhibiting Opportunities or Group Discounts? Contact us at Which certification is right for you? Which eNewsletters are right for you? Call to speak with a specialist now.

Which books are right for you? Call to speak to a representative. Roache4 , Patricia A. Chronic Stress Volume 3: 1— Michelle J. Bovin, Erika J. Wolf and Patricia A. Frontiers in Psychiatry doi: Chard, K. An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse.

Journal of consulting and clinical psychology , 73 5 , Kirsten H. Dillon, Willie J. Hale, Stefanie T. LoSavio Duke, Jennifer S. Wachen, Kristi E. Pruiksma, Jeffrey S. Yarvis, Jim Mintz, Brett T. Litz, Alan L. Behavior Therapy 51 — Katherine A. Dondanville, Abby E. Blankenship, Alma Molino, Patricia A. Yarvis, Brett T. Litz, Elisa V. Borah, John D. Hembree, Alan L. Qualitative examination of cognitive change during PTSD treatment for active duty service members.

Behaviour Research and Therapy. Hale, Jim Mintz, John D. Roache, Cody Carson, Brett T. Litz, Jeffrey S. Peterson, Patricia A.

Journal of Traumatic Stress. April , 32, — Galovski, T. Journal of Consulting and Clinical Psychology , 80 6 , Does cognitive-behavioral therapy for PTSD improve perceived health and sleep impairment? Journal of Traumatic Stress, 22, Iverson, K. L, Resick, P. K, Smith, K. Cognitive-behavioral therapy for PTSD reduces risk for intimate partner violence.

Journal of Consulting and Clinical Psychology, 79, Vanessa M. October , 32, — Karlin, B. Dissemination of evidence-based psychological treatments for posttraumatic stress disorder in the Veterans Health Administration. Journal of Traumatic Stress, 23, Kelly, K. The impact of sudden gains in cognitive behavioral therapy for posttraumatic stress disorder. Macdonald, A. Identifying patterns of symptom change during a randomized controlled trial of cognitive processing therapy for military-related posttraumatic stress disorder.

Journal of Traumatic Stress, 24, Are the books printed in color? When do AAPC books ship? Are refunds or cancellations allowed? Which edition books should I use? What other resources are allowed? Refer to the chart below to find the books and resources allowed at various exams. No other publisher is allowed. Highlighting, underlining and brief notations needed for day- to-day coding is permitted on the printed side of the page.

Long passages of information are not permitted on the blank pages of the print out. Anatomical charts or pictures of the vascular tree. These may have codes on them. Both volumes of the Coding Companion. One reference of your choice. This does allow Medical Dictionary.

Where can I find updates, new codes, and errata for the books? Is there modifier information in the AAPC code books? Is there an easy way to see the new, revised, and deleted codes in the AAPC code books? Can these books help me with learning anatomy and terminology? Do the AAPC code books have space for me to add my own notes? Some of the key features of AAPC eBooks are: Create and update Digital Flashcards Highlight important lines and save custom notes Share notes with other users Use the search bar to find anything you need Access your eBooks from any of your devices Bookmark pages to easily find your favorites eBooks can be accessed online or offline Note: Purchased eBooks may not be printed and are non-refundable.

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However, these findings could be strengthened by documenting improvements in client acceptability—data which we lack at this stage of pilot testing.

Consistent with the iterative nature of formative evaluation, there are also likely additional factors that may warrant further adaptation of the manual, such as provider modifications to delivery of CPT.

Future studies should examine how providers make in-session modifications to manuals, because these data could identify areas in need of further adaptation.

Further, given that implementation researchers are interested in increased adoption as well as fidelity to EBTs, more research is needed on the way that providers modify EBTs to fit their own style of practice and the needs of their clients.

Training of providers in community health centers, particularly those with some resistance to delivering EBTs, may be enhanced by adaptations that are guided by feedback from providers. For example, having providers identify terminology to describe key CPT concepts that is more congruent with their own beliefs regarding diagnosis and treatment of mental health problems may increase adoption as well as fluidity with CPT principles.

Although not a primary aim of this study, the training workshop for the Spanish CPT Manual—Version 2 included modified language of some terms that providers deemed too pathologizing or invalidating to clients e. Cultural adaptations that enhance provider adoption of interventions warrant further exploration. Another limitation of the current study is that only one provider was trained in both versions of the Spanish manual, so data directly comparing the two manuals is limited.

Interestingly, though, the Spanish CPT Manual—Version 2 did not emerge as a major barrier to implementation in subsequent interviews. This finding suggests that the manual revision improved the acceptability and appropriateness of CPT, as intended. Future studies may benefit from head-to-head comparisons of culturally adapted versus original EBTs; this research is needed to justify ongoing support of translational research.

The systematic inclusion of suggested revisions to the Spanish CPT Manual appears to have improved acceptability and appropriateness of the intervention, which, in turn, reduced the degree to which the manual was a barrier to implementation. Our qualitative findings suggest that attending to cultural context beyond simply organizational culture within implementation trials may improve implementation outcomes such as acceptability and appropriateness of EBTs.

In addition, our findings highlight the utility of formative evaluation in both implementation science and cultural adaptation research. Future studies should further investigate the intersection between cultural adaptation and implementation science by examining the tension between latitude and fidelity.

Because previous studies have found that culturally adapted interventions may be more effective among Latino clients, implementation scientists should aim to test how EBTs can be culturally adapted without reducing the potency of the intervention.

Our findings suggest that community mental health providers are less likely to adopt EBTs that are perceived as cumbersome or ill-fitting to their clients; thus, cultural adaptation may be necessary to move EBTs from research to usual care settings. We recommend a full-scale mixed-methods clinical trial of the Spanish CPT Manual—Version 2 to facilitate a more extensive culturally-informed modifications to the Spanish language manual, and b provide quantitative data supporting the efficacy of the adapted intervention.

We would like to thank the hospital administration, the providers, and the patients who participated in this trial and provided invaluable feedback necessary for this manuscript. Sarah E. Christina P. Adin S. Patricia A. J Clin Psychol. Author manuscript; available in PMC Mar 1.

Valentine , Christina P. Borba , Louise Dixon , Adin S. Find articles by Luana Marques. Author information Copyright and License information Disclaimer. Phone: Fax: Copyright notice.

The publisher's final edited version of this article is available at J Clin Psychol. Results Data-driven refinements included adaptations related to cultural context i. Conclusion Our study reinforces the need for dual application of cultural adaptation and implementation science to address the PTSD treatment needs of Spanish-speaking clients. Keywords: implementation, cultural adaptation, posttraumatic stress disorder, Latinos, cognitive processing therapy.

Methods Participants This study is part of a larger implementation trial that evaluated the feasibility and acceptability of CPT for PTSD in a diverse community health center. Table 1 Demographics for Stage 3, 4, and 5 providers and clients. Open in a separate window.

Procedures Modifications to the CPT Manual are presented according to the five-stage theoretical model for cultural adaptations Barrera et al. Stage 1: Information Gathering Information gathering in Stage 1 involves literature review, pre-adaptation interviews, and other means of determining whether or not an adaptation is needed and which components of the intervention should be altered during the adaptation.

Stage 2: Preliminary Adaptation Design Information gathered in Stage 1 was used to inform preliminary adaptation design, including changes to the original intervention. Qualitative Data Analysis The coding team consisted of four undergraduate research assistants, supervised by the principal investigator of the study. Data collection Study procedures were the same as Stage 3. Qualitative Data Analysis The coding team consisted of two undergraduate research assistants and one bachelor's level research assistant, supervised by a doctoral-level researcher.

Many providers perceived the manual as difficult to use, even if they had already used the English language version. Based on the qualitative data integration, several terms used in the original CPT Spanish language manual were identified as either being poor translations e. Difficult to use. Some providers perceived the Spanish CPT Manual—Version 2 as difficult to use, although there were far fewer comments about challenges using this iteration of the manual than there were about using the Spanish CPT Manual—Version 1.

Manual layout. Providers reported that one of the strengths of the English language manual is its visual organization. For example, each section is well-organized, with section headings, a readable font size, and other visual cues that assist in material comprehension.

The Spanish language manual was adapted to mirror these aspects of the English language manual. Additionally, we added delineated checklists for session agendas, and separated therapist considerations from the bulk of the session material. These changes were made to facilitate provider administration of the intervention to clients. In addition, providers felt that many specific concepts from the manual were difficult to explain in Spanish or lacked suitable Spanish translations.

Multiple key terms e. Fit with literacy and education level of clients. I'm not familiarized with all these terms. We added example dialogue that might be more related to the types of trauma often experienced by clients in community health centers, such as community violence, domestic violence, physical assault, and gang violence.

Worksheets and handouts were also revised accordingly. Although no providers explicitly reported poor fit with regard to client literacy and education levels of the Spanish CPT Manual—Version 2, there were a few mentions of clients being confused by session materials and homework assignments.

It requires a little interpretation. To address prominent concerns regarding literacy level of the material, we integrate another adaptation of the CPT manual, developed for use with clients with low education and literacy. Handouts and worksheets. Homework difficulty and compliance was one of the biggest barriers to implementation of CPT Spanish in this trial. In order to address the concerns of the providers and clients in this study, we revised client handouts and worksheets to be more easily understood, both visually and linguistically.

In addition to changing the terminology, as discussed previously, we altered the formatting of the worksheets, and provided visual cues so that clients would be able to more easily complete homework outside of session. Cultural relevance of Clinical Examples. The English CPT Manual provides several client dialogue examples that pertain exclusively to veterans.

Although some therapists may be able to create novel and relatable examples for their clients based on these veterans examples, many providers expressed difficulty with this task.

Provider fluency Providers repeatedly discussed concerns regarding their own Spanish-language fluency, when attempting to implement the Spanish CPT Manual—Version 1. Due to provider-level difficulties with the language, one provider described how she shifted between both the English and Spanish version during session, I kind of liked doing it [with the English and Spanish Manuals] side by side, because I found more [self-] efficacy She described how training in English made it challenging for her to gain fluidity with the CPT terminology that she would later be used in sessions with Spanish-speaking clients, Personally Client education and literacy level Providers described various experiences where they perceived that clients had a difficult time understanding the concepts taught through CPT.

As one provider described, I wonder though too, because it's a [literacy] level thing. Another provider noted, The other part is [that]- I, myself as a [native] Spanish fluent speaker, some of the wording on the worksheet is definitely not basic wording.

Another provider noted how one of her clients was able to comprehend therapy content, despite challenges with the level of the language, And I mean, I think it [CPT] can be done, honestly, in Spanish, because [my client] only has a third grade level and she's been able to move along very nicely in this.

One provider suggested, But I do know from reading the worksheets and seeing them struggle that definitely the language is complicated for them, and, um pause and I wonder if we can, um adapt the language to make it simpler for when they go home, [so then] they can remember what we're discussing and working on.

Another provider noted, I know she [my supervisee] talked about, you know, the complicated nature of doing that [adapting the Spanish manual] and I was thinking it would almost be like somebody who works in this community and works with our population would Terminology Beyond challenges with client literacy and provider fluency, providers also noted that some of the terminology was not relevant to dialects of clients seen at the clinic.

Manual Burden and Low Adoption Over the course of the trial, providers discussed how challenges with the manual, especially the Spanish CPT Manual—Version 1, decreased their desire to continue using the treatment. Table 3 Key Terminology. As one provider noted, And I really liked the new first homework assignment where trying to get the person to imagine what their life could be like if their symptoms were lower. This provider noted, Um, we added some [stuck points to the log] while we were in session, but I felt that the session is not long enough to cover all the material in a way that More specifically, the provider stated that, The pacing is better.

Conclusion The systematic inclusion of suggested revisions to the Spanish CPT Manual appears to have improved acceptability and appropriateness of the intervention, which, in turn, reduced the degree to which the manual was a barrier to implementation. Acknowledgements We would like to thank the hospital administration, the providers, and the patients who participated in this trial and provided invaluable feedback necessary for this manuscript.

Contributor Information Sarah E. Evidence-based practice implementation and staff emotional exhaustion in children's services. Behaviour Research and Therapy. Hispanic Journal of Behavioral Science. Clinical Psychology Review. Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychological Services. Community health center provider and staff's Spanish language ability and cultural awareness.

Journal of Health Care for the Poor and Underserved. Cultural adaptations of behavioral health interventions: A progress report. Journal of Consulting and Clinical Psychology. Controlled trial of psychotherapy for Congolese survivors of sexual violence. New England Journal of Medicine. Cultural adaptation and implementation of evidence-based parent-training: A systematic review and critique of guiding evidence.

Children And Youth Services. Culturally adapted psychotherapy and the legitimacy of myth: A direct-comparison meta-analysis. Journal of Counseling Psychology. Cultural adaptation of treatments: A resource for considering culture in evidence-based practice. Professional Psychology: Research and Practice.

The role of language in training psychologists to work with Hispanic clients. Professional Psychology: Research And Practice. A two-way street: Bridging implementation science and cultural adaptations of mental health treatments. Implementation Science. Crisis visits and psychiatric hospitalizations among patients attending a community clinic in rural southern California. Community Mental Health Journal.

Challenges of providing mental health services in Spanish. Does cognitive-behavioral therapy for PTSD improve perceived health and sleep impairment? Journal of Traumatic Stress, 22, Iverson, K. L, Resick, P. K, Smith, K. Cognitive-behavioral therapy for PTSD reduces risk for intimate partner violence. Journal of Consulting and Clinical Psychology, 79, Vanessa M.

October , 32, — Karlin, B. Dissemination of evidence-based psychological treatments for posttraumatic stress disorder in the Veterans Health Administration. Journal of Traumatic Stress, 23, Kelly, K.

The impact of sudden gains in cognitive behavioral therapy for posttraumatic stress disorder. Macdonald, A. Identifying patterns of symptom change during a randomized controlled trial of cognitive processing therapy for military-related posttraumatic stress disorder. Journal of Traumatic Stress, 24, Stefanie T. LoSavio, Robert A. Murphy, and Patricia A. Shannon R. Miles, Kirsten H. Dillon, Vanessa M. Jacoby, Willie J.

Hale, Katherine A. Yarvis, Alan L. Peterson, Jim Mintz, Brett T. Monson, C. Change in posttraumatic stress disorder symptoms: Do clinicians and patients agree?

Psychological Assessment, 20, Changes in social adjustment with cognitive processing therapy: Effects of treatment and association with PTSD symptom change. Journal of Traumatic Stress,25 5 , Treating combat PTSD through cognitive processing therapy. Federal Practitioner, 22, Cognitive processing therapy for veterans with military-related posttraumatic stress disorder.

Journal of consulting and clinical psychology , 74 5 , John C. Moring, Katherine A. Dondanville , Brooke A. LoSavio, Stephanie Y. Wells, Leslie A. Morland, Debra Kaysen, Tara E. Galovski, and Patricia A. Moring, Erica Nason , Willie J. Dondanville, Casey Straud, Brian A. Moore, Jim Mintz, Brett T.

Conceptualizing comorbid PTSD and depression among treatment-seeking, active duty military service members. Journal of Affective Disorders — Kristi E. Peterson, Elisa V. Borah, Brett T. Litz, Patricia A. Temporary codes describing new services and procedures can remain in Category III for up to five years.

If the services and procedures they represent meet Category I criteria — which includes FDA approval, evidence that many providers perform the procedures, and evidence that the procedures have proven effective — they will be reassigned Category I codes.

Conversely, Category III codes can be eliminated if providers do not use them. First, as you might imagine, procedural coding necessitates a solid grasp of anatomy and medical terminology. One procedure might have numerous variations, differing only slightly, and selecting the right code will require an ability to comprehend the clinical documentation and code description — to understand what a given procedure is, how the physician performed it, and which code descriptor captures the highest specificity of the procedure performed.

The codes a provider can report are not limited by the specialty in which they practice. For example, X-ray codes are listed under radiology, but a primary care coder will be required to assign an appropriate X-ray code if the primary care physician interprets an X-ray. This is the best way to ensure coding accuracy and optimal reimbursement for your employer. A modifier consists of two numbers, two letters, or a number and a letter. For example, some modifiers show that a procedure was performed on the right side of the body, versus the left side or both sides.

Other modifiers indicate that a physician took extra time and effort to perform a service or procedure. A short list of modifiers goes a long way in expanding the ability to report the unique circumstances of services and procedures performed. Examples of services, supplies, and items with HCPCS Level II codes include orthotic and prosthetic procedures, hearing and vision services, ambulance services, medical and surgical supplies, drugs, nutrition therapy, and durable medical equipment.

An example of a diagnosis and service meeting medical necessity is when a patient comes into a medical office complaining of stomach pain, and the physician conducts a physical examination. The stomach pain diagnosis justifies the reason for the examination service.

Cpt manual pdf.AMA CPT Professional 2024 - eBook

During this stage, we conducted a preliminary adaptation test using the Spanish CPT Manual—Version 1 and then gathered feedback from stakeholders. Feedback on the Spanish CPT Manual—Version 1 came from multiple qualitative data sources, including CPT sessions, provider field notes following each CPT session, weekly consultation meetings, and researcher field notes on CPT sessions written by trained bilingual-bicultural undergraduate-level research assistants.

What did not go well during this session? What are some of the barriers to the CPT protocol that you experienced during this session? What would make it easier to administer CPT the next time you see this client?

Do you have any other impressions of the session or important things to note? At the end of the consultation period, providers participated in 1-hour follow-up interviews with a member of the study staff to discuss their experiences with training in CPT, receiving CPT consultation, and implementing CPT in their practice. Two bilingual-bicultural research assistants recorded daily researcher field notes on qualitative data from CPT session audio to document needed changes to the CPT manual based on the following criteria: A direct feedback from providers as part of provider field notes and consultation qualitative data, B observation of common challenges documented through audio review of CPT sessions, and C own recommendations of linguistic modifications needed to better fit the Latino population at the urban community health center.

The coding team consisted of four undergraduate research assistants, supervised by the principal investigator of the study. Two coders were assigned to code qualitative data gathered through CPT sessions and provider field notes, and two coders were assigned to code data gathered through consultation team meetings. Each coding pair followed the procedures of conventional content analysis, whereby coding categories were developed as data were reviewed.

In order to generate coding categories, all four coders independently coded 10 transcripts. The coders then met and discussed these themes as a team in order to generate an initial codebook. Each member of the coding team then used this initial codebook to code an additional 10 transcripts from their respective data sources. When the coders met, they discussed any emerging themes or disagreements.

Each coder had to agree on how a transcript should be coded. This process proceeded until theoretical saturation was reached and no new themes emerged. Researcher field notes were integrated with clinical observations of the principal investigator.

Data were triangulated to form firm recommendations for revisions. The development of the Spanish CPT Manual—Version 2 was spearheaded by our bilingual-bicultural research assistants, under the close supervision of two doctoral-level research staff with extensive clinical experience with CPT.

To verify improvement, one provider who participated in Stage 3 continued to enroll clients at Stage 5. This provider is the only provider to deliver both versions of the Spanish CPT Manual as part of the implementation trial.

The coding team consisted of two undergraduate research assistants and one bachelor's level research assistant, supervised by a doctoral-level researcher. Each coding pair followed the procedures of directed content analysis, whereby an existing codebook developed during Stage 3 was used to code the data.

When asked about specific conditions for which they would like to receive EBT training, these same providers overwhelmingly favored PTSD. Providers and administrators perceived that a high percentage of their clients experienced trauma and likely met criteria for PTSD per self-report. Our review of the literature revealed several factors to consider when adapting interventions for Latinos seen in community health settings, including ways of adapting inventions to fit education and literacy levels of clients.

More specifically, our review of the literature highlighted that poor English skills, minimal education, lack of familiarity with Western psychological concepts and culturally specific idioms of distress e. Moreover, research indicates that differences in cultural values e. Because it was publicly available, we used the existing Spanish CPT Manual—Version 1 as our preliminary adaptation design. Avendano; per P. Resick, personal communication, September 28, During Stage 3 of the study, four providers used the Spanish CPT Manual—Version 1 with a total of 10 clients each provider enrolled 2 or 3 clients.

Clients who received treatment with the Spanish CPT Manual—Version 1 evidenced difficulties understanding directions on homework assignments, key terminology, and the relevance of the trauma vignettes provided in the manual.

Triangulated data from this stage also see Table 2 suggests that the Spanish CPT Manual—Version 1 was a poor fit for clients and providers alike. That's not even mentioned in the Spanish one. Bilingual providers noted specific challenges they faced as they tried to compensate for the shortcomings of the Spanish CPT Manual—Version 1. For example, providers noted how they attempted to translate from English to Spanish as well as from language in Spanish Manual— Version 1 to the client's dialect while in session.

One provider highlighted concerns regarding the equivalence of the CPT that was delivered to Spanish- versus English-speaking clients.

It's like a different procedure. Providers repeatedly discussed concerns regarding their own Spanish-language fluency, when attempting to implement the Spanish CPT Manual—Version 1. Due to provider-level difficulties with the language, one provider described how she shifted between both the English and Spanish version during session,.

I kind of liked doing it [with the English and Spanish Manuals] side by side, because I found more [self-] efficacy I feel like my fluency Another provider a non-native Spanish speaker noted vocabulary difficulties when attempting to explain concepts in Spanish, as she had been able to do in English.

She described how training in English made it challenging for her to gain fluidity with the CPT terminology that she would later be used in sessions with Spanish-speaking clients,. I feel like I'm not doing a good job teaching them because they're not the ones [terms] I've learned [in training] Providers described various experiences where they perceived that clients had a difficult time understanding the concepts taught through CPT.

Providers expressed their belief that client education and literacy level likely contributed beyond language to some challenges observed in session. As one provider described,. I wonder though too, because it's a [literacy] level thing. Like even if you got the grammar completely right, I think sometimes I felt like there was a disconnect with I felt The other part is [that]- I, myself as a [native] Spanish fluent speaker, some of the wording on the worksheet is definitely not basic wording.

Some of the language is complicated. It's not Another provider noted how one of her clients was able to comprehend therapy content, despite challenges with the level of the language,. And I mean, I think it [CPT] can be done, honestly, in Spanish, because [my client] only has a third grade level and she's been able to move along very nicely in this.

Providers were strong proponents of adapting the language in the manual to the literacy level as well as the dialect of the clients seen in the clinic. One provider suggested,. But I do know from reading the worksheets and seeing them struggle that definitely the language is complicated for them, and, um pause and I wonder if we can, um adapt the language to make it simpler for when they go home, [so then] they can remember what we're discussing and working on.

I know she [my supervisee] talked about, you know, the complicated nature of doing that [adapting the Spanish manual] and I was thinking it would almost be like somebody who works in this community and works with our population would Beyond challenges with client literacy and provider fluency, providers also noted that some of the terminology was not relevant to dialects of clients seen at the clinic.

So I could use some coaching around that. I remember just trying to describe the concept of a pattern. The word that is used, patron , they didn't understand and so then I was trying to think of other words. How do you explain the concept of a pattern? And it was really hard, I took awhile. Over the course of the trial, providers discussed how challenges with the manual, especially the Spanish CPT Manual—Version 1, decreased their desire to continue using the treatment.

Thus, these issues were identified as barriers to implementation. I'm a hard worker, but this was labor intense. The CPT-DRC manual preserved core elements of the original intervention, but simplified language to increase comprehension and retention for low-literacy and illiterate participants.

Further details provided in supplementary appendix to Bass et al. Prior to the cultural adaptation trial, we also consulted with CPT experts to ensure fidelity of the revised manual to the basic principles of CPT. Feedback and revisions to the manual are presented in Table 2. In addition, we integrated new terms that were found to be a better fit for the variations of Spanish used by clients at the community mental health center see Table 3.

We then met with native Spanish-speaking providers and researchers to discuss the initial acceptability of key terminology and the revised manual. Generally speaking, qualitative data from Stage 5 included markedly fewer mentions of the Spanish CPT Manual—Version 2, as well as more positive feedback.. As one provider noted,. And I really liked the new first homework assignment where trying to get the person to imagine what their life could be like if their symptoms were lower.

It was really hard for my patient to imagine anything being different, but Providers also reported some ongoing challenges related to client comprehension of a narrow set of CPT concepts, although they reported notably fewer challenges with client comprehension compared to the previous set of providers. One provider stated that it took longer to get through the materials in Spanish compared to English , and that she wished that the clinic would accommodate more time for these types of treatments.

This provider noted,. Um, we added some [stuck points to the log] while we were in session, but I felt that the session is not long enough to cover all the material in a way that I feel that we could have spent a little bit more time on finding those stuck points and writing them down, and processing them.

Another provider described her own limited fluency, but noted that the client was able to understand the terminology in the Spanish CPT Manual—Version 2. We did discuss it [the concept], but we didn't do it in the order, uh, indicated, and, um, I had a little trouble reading all the Spanish, it was a little bit Provider also described how they were working to improve their ability to determine if client's misunderstanding of key concepts was related to cognitive difficulties, avoidance, or simply due to the sophistication of CPT concepts.

The questions. I'm having a tough time interpreting it to the client and I'm not sure whether I'm doing as good of a job as I could be doing or if he's having other issues like avoidance or cognitive or — so I just don't know the language to use. More specifically, the provider stated that,. The pacing is better. It seems like some of the psycho ed [psychological education] is broken up more over the sessions.

It's not a mad dash to just like get through it all. And now we still call it avoidance, but the other two terms [were] changed So I feel like the psycho ed is spread out better, [and] the language is clearer and at a more accessible level for my patients. We detailed the cultural adaptation of the CPT manual to fit both client and provider preferences in community mental health settings.

Specifically, we describe both superficial and deep structure adaptations related to cultural context i. Our desired outcome for manual adaptation was to enhance implementation of CPT within the parent study.

Our manuscript expands upon the current literature by describing how cultural adaptation methodologies and implementation science outcomes were dually applied to address the PTSD treatment needs of Latino community mental health clients.

Initial pilot testing of the Spanish CPT Manual—Version 1, revealed several aspects of the manual related to poor acceptability of the manual by providers, and, subsequently poor adoption of the EBT for use with Spanish-speaking clients. This feedback suggests that the initial translation of the manual was a poor fit with regard to terminology, sociocultural context, education level, and health literacy.

Given that providers in this study were new to CPT, providers described experiencing marked difficulty generating varied ways of describing key concepts—concepts that they had recently learned themselves. Our findings also suggest that language match between translated interventions and clients is not sufficient, thus, we caution providers from using manuals that have been translated, but have not undergone cultural adaptation and pilot testing or simply do not match the regional dialect of clients.

Providers and clients reported a desire for case examples that reflected exposure to community violence, interpersonal violence including physical assault and rape , and violence experienced prior to immigration to the U.

Further, providers reported that their clients were often experiencing ongoing violence, whereas the examples in the manual referred to veterans who were no longer being exposed to combat in their daily lives.

Some providers expressed that the manual's inattention to ongoing trauma exposure made CPT for PTSD inherently less acceptable for their own clients. The need for culturally relevant intervention content has been demonstrated in prior studies of cultural adaptations of EBTs for Latinos Parra-Cardona et al.

Our findings also suggest that cultural adaptation may be necessary to increase provider adoption of EBTs for diverse clients. Due to significant challenges in using the Spanish CPT Manual—Version 1 in session, some providers decided to not use the manual to guide sessions.

The choice by some providers to abandon the manual altogether posed additional concerns regarding fidelity to CPT. A true strength of both cultural adaptation and implementation science methodology, in-depth interviews with providers allowed us to synthesize recommended revisions to the Spanish manual prior to training a second set of providers at the same community mental health center.

Providers gave specific feedback on changes to the manual beyond language and literacy adjustments that could facilitate implementation, such as improving the visual organization of therapy materials i. These adjustments are consistent with Cabassa and Baumann's recommendations for integrating key components of cultural adaptation and implementation science.

Journal of Traumatic Stress, 24, Stefanie T. LoSavio, Robert A. Murphy, and Patricia A. Shannon R. Miles, Kirsten H. Dillon, Vanessa M. Jacoby, Willie J. Hale, Katherine A. Yarvis, Alan L. Peterson, Jim Mintz, Brett T. Monson, C. Change in posttraumatic stress disorder symptoms: Do clinicians and patients agree?

Moring, Erica Nason , Willie J. Dondanville, Casey Straud, Brian A. Moore, Jim Mintz, Brett T. Conceptualizing comorbid PTSD and depression among treatment-seeking, active duty military service members.

Journal of Affective Disorders — Kristi E. Peterson, Elisa V. Borah, Brett T. Litz, Patricia A. Resick, Daniel J. Yarvis, Carl R. Darnall, Katherine A. Dondanville, Elizabeth A. Amy E.

Ramage, Brett T. Resick, Mary D. Woolsey, Katherine A. Borah, Elisa V. Borah, Alan L. Peterson, Peter T. Regional cerebral glucose metabolism differentiates danger- and non-danger-based traumas in posttraumatic stress disorder. Social Cognitive and Affective Neuroscience, , — Patricia A. Resick, Stefanie T. Dillon, Erica E. One discrepancy to the expected order involves resequenced codes.

A resequenced code comes about when a new code is added to a family of codes but a sequential number is unavailable. This arrangement, as with resequenced codes, is designed for coding efficiency. Category II codes, consisting of four numbers and the letter F, are supplemental tracking and performance measurement codes that providers can assign in addition to Category I codes.

Providers use Category II codes — which track specific information about their patients, such as whether they use tobacco — to help deliver better healthcare and achieve better outcomes for patients. These codes are arranged as follows:. Category III codes are temporary codes that represent new technologies, services, and procedures.

Temporary codes describing new services and procedures can remain in Category III for up to five years. If the services and procedures they represent meet Category I criteria — which includes FDA approval, evidence that many providers perform the procedures, and evidence that the procedures have proven effective — they will be reassigned Category I codes.