The 2024 edition of ICD-10-CM G71. 2). This is the American ICD-10-CM version of K52. Introduction. 89 may differ. 5 Kuwabara S, Isose S, Mori M, et al. However, there are some tests and tools doctors use to help assess patients. G61. There is evidence for effectiveness with agents such as rituximab, especially in DADS-M, and this medication can also be used in cases refractory to conventional IMTs. The 2024 edition of ICD-10-CM G61. Translations. Codes Copy. It is found in the 2024 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2023 - Sep 30, 2024 . The following code (s) above G62. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired demyelinating peripheral neuropathy of presumed autoimmune etiology. 10 Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. LCD is revised to add diagnosis G61. 9 may differ. This is the American ICD-10-CM version of Q82. Some of them, such as Neurofascin 155 /186, or Contactin 1 antibodies have been associated with distinct clinical presentations and response to. 2024 ICD-10-CM Codes. 00 – Hypercholesterolemia. Objective: To characterize an acquired, symmetric, demyelinating neuropathic variant with distal sensory or sensorimotor features. CIDP diagnosis was identified by International Statistical Classification of Diseases and Related Health Problems (ICD), Ninth Revision, Clinical Modification diagnosis code 357. ICD-10-CM Diagnosis Codes. 03. 3 became effective on October 1, 2023. Chronic means that the disease occurs over a long period of time. Page 69 of 313. Short description: Chr inflam polyneuritis. Because of the similarity of symptoms, clinicians have long considered CIDP to be a chronic form of Guillain-Barre syndrome. 1212/WNL. 59 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2023/2024 codes became effective on October 1, 2023, therefore all claims with a date. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is probably the best recognized progressive immune-mediated peripheral neuropathy. The following CPT/HCPCS codes were considered as CIDP related procedures. This section shows you chapter-specific coding guidelines to increase your understanding and correct usage of the target ICD-10-CM Volume 1 code. In an autoimmune disease, the body attacks its own tissues. To code a diagnosis of this type, you must use one of the four child codes of G61 that describes the diagnosis 'inflammatory polyneuropathy' in more detail. The prevalence of chronic inflammatory demyelinating polyneuropathy (CIDP)—the most common chronic acquired demyelinating polyneuropathy—depends on the diagnostic criteria used in the. Symptoms of chronic inflammatory demyelinating polyneuropathy (CIDP) resemble those of Guillain-Barré syndrome Guillain-Barré Syndrome (GBS) Guillain-Barré syndrome is an acute, usually rapidly progressive but self-limited inflammatory polyneuropathy characterized by muscular weakness and mild distal sensory loss. Als eigene von der CIDP unabhängig zu sehende Erkrankungen werden Neuropathien gewertet, bei denen Antikörper gegen (para)nodale Proteine vorhanden sind (z. 1016/j. 81 or ICD, Tenth Revision, Clinical Modification diagnosis code G61. Methods: This clinical trial was conducted on 40 patients diagnosed with CIDP randomly allocated to treatment with 100-500 mg gabapentin (n=20) or 50-300 mg pregabalin (n=20) both co-medicated with 37. G61. This is the American ICD-10-CM version of G40. This is the American ICD-10-CM version of G63 - other international versions of ICD-10 G63 may differ. 42 may differ. 9 - other international versions of ICD-10 I42. ICD-10-CM/PCS MS-DRG v35. 1 [convert to. CIDP is caused by damage to the covering of the nerves, called myelin. G61. In 1975, Dyke et al. 81) is a medical classification listed by WHO under the range of nervous system diseases. 42 became effective on October 1, 2023. S. 8 or G61. This codelist was developed in order to exclude people who would not be eligible for a diagnosis of Guillain Barre Syndrome due to an existing diagnosis of chronic inflammatory demyelinating. 2021. Code. 14 may differ. Diagnostic criteria can be essential to. ICD-10-CM code G61. ICD-10-CM Code I31. 819 - other international versions of ICD-10 G43. Diagnosis and treatment of chronic acquired demyelinating polyneuropathies. Diseases of the nervous system. ICD10Data. Download the Prescription Referral Form to confirm insurance coverage options. 4 Selective deficiency of immunoglobulin M [IgM] Under ICD-10-CM Codes that Support Medical Necessity Group 1: Codes added D81. 21 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 9. Am J Manag Care. 2018. 27708. Methods: We took advantage of a switch in coding systems from ICD-9 to ICD-10 to independently review stroke patient charts. 81 should only be used for claims with a date of service on or before September 30, 2015. The availability of International Classification of Diseases (ICD), Ninth Revision (ICD-9) or ICD-10 codes for CIDP will help identify patients with CIDP and will. Chronic inflammatory demyelinating polyneuropathy (CIDP) is rare but the most common chronic immune-mediated neuropathy; however, the effects of pregnancy on CIDP have never been investigated except case reports or series. The 2024 edition of ICD-10-CM K52. CIDP is diagnosed according to the European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) criteria, which combine clinical features with the electrophysiological evidence of demyelination. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a slowly developing autoimmune disorder in which the body's immune system attacks the myelin that insulates and protects your body’s nerves. report flag outlined. J20. 81 is the CIDP diagnosis code that is included in the Medicare coverage policy. 12 - other international versions of ICD-10 G96. CIDP (Chronic Inflammatory Demyelinating Polyneuropathy) Approved ICD-10 codes for PIDD (Primary Immune Deficiency Disorders): D80. Viral pneumonia, unspecified. 19 were added to Group 1 under "ICD-10 Codes that Support Medical Necessity. 9 - other international versions of ICD-10 I63. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2024 ICD-10-CM Range G00-G99. Browse all the diagnosis codes used for. Get crucial instructions for accurate ICD-10-CM Z63. F14. 500 results found. Bouchard C, Lacroix C, Plante V, et al. 026. G59 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 9 Inflammatory polyneuropathy, unspecified. 9 : G00-G99. There are 0 terms under the parent term 'Cidp' in the ICD-10-CM Alphabetical Index . 89 - Other inflammatory polyneuropathies. G61 - Inflammatory polyneuropathy. 8 Other disorders of purine and pyrimidine metabolism. 1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. INTRODUCTION — Chronic inflammatory demyelinating polyneuropathy (CIDP; also known as chronic inflammatory demyelinating polyradiculoneuropathy) is an acquired, immune-mediated neuropathy affecting peripheral nerves and nerve roots, typically characterized by a relapsing-remitting or progressive. Under Article Title title was changed to Billing and Coding: Rituximab. In this review, we examine the current treatment approaches to each of these CIDP variants based on existing data. 10. 81 should only be used for claims with a date of service on or before September 30, 2015. 1136/jnnp-2014-308452 [Google Scholar]What is chronic inflammatory demyelinating polyneuropathy? Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare neurological disorder that affects the nerve roots and peripheral nerves in the body, resulting in weakness/paralysis and impairment in motor function, especially of the arms and legs. 4 Type 2 diabetes mellitus with neurological complications. Your message * (3000 characters remaining). Introduction: Distal acquired demyelinating symmetric polyneuropathy (DADS) is proposed as a distinct entity from classic chronic inflammatory demyelinating polyneuropathy (CIDP). Charcot-Marie-Tooth disease; Déjérine-Sottas disease; Hereditary motor and sensory neuropathy, types I-IV; Hypertrophic neuropathy of infancyBackground The diagnostic value of new criteria of the European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) for chronic inflammatory demyelinating polyneuropathy (CIDP) is unknown. Symptoms of weakness and sensory loss progress beyond 8 weeks. 42 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 71-A04. Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare neurological disorder in which there is inflammation of nerve roots and peripheral nerves and destruction of the fatty protective covering (myelin sheath) of the nerve fibers. 273621. 8. 81 is a valid billable diagnosis code for chronic inflammatory demyelinating polyneuropathy (CIDP), a condition that causes nerve. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 81. Short description: Diseases of the nervous sys comp pregnancy, unsp trimester The 2024 edition of ICD-10-CM O99. 0 may differ. Acute inflammatory demyelinating polyneuropathy (AIDP) is an autoimmune process characterized by progressive areflexic weakness and mild sensory changes. 9 became effective on October 1, 2023. 2. 9 became effective on October 1, 2023. 82, effective 10/1/2016 per the 2016/2017 annual ICD-10 update. 1038/nrneurol. 9 may differ. coding and determination of the appropriate ICD-10-CM codes1 that describe the patient’s condition and are supported by the medical record. 81 is the appropriate modern ICD10 code. Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy and should be considered in any patient with progressive polyneuropathy with the progressive course for over 2 months. Purpose. E11. B. 521 - other international versions of ICD-10 O09. 9 coding with all applicable Excludes 1 and Excludes 2 notes from the section level conveniently shown with each code. Among the 221 responders who entered Stage B, treatment with efgartigimod alfa plus hyaluronidase-qvfc reduced the risk for CIDP relapse (primary endpoint) by 61% at week 48 compared with placebo. ICD-10-CM Coding Rules. Chronic inflammatory demyelinating polyneuritis ( ICD-10 code G61. This is the American ICD-10-CM version of J12. 21 Despite purely sensory. Muscle weakness typically begins in the arms and then moves to the legs. . Your message * (3000 characters remaining). 819 became effective on October 1, 2023. The following code(s). Polyneuropathy means that the disease affects more. G61. FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. . G1 became effective on October 1, 2023. The 2024 edition of ICD-10-CM G62. The main part of the nerve that is attacked is the insulating sheath, or myelin. Nomenclature and/or coding. unspecified G60. (2572) 21 cidp. The CPT®,2-4 HCPCS,5,6 and ICD-10-CM codes provided are based on AMA or CMS guidelines. 59 - other international versions of ICD-10 G47. 81 Chronic inflammatory demyelinating polyneuritis. This is the American ICD-10-CM version of G71. Cause is thought. Eur J Neurol 2021 doi: 10. There’s no blood test for CIDP. G61 - Inflammatory polyneuropathy. Effective for dates of service on or after October 1, 2014, via CR8605, the appropriate ICD-9 codes were converted to the following ICD10 codes: D80. The 2024 edition of ICD-10-CM Y93. Acute-onset chronic inflammatory demyelinating polyneuropathy with cranial nerve involvement, dysautonomia, respiratory failure, and. Typical CIDP involves motor and sensory nerve dysfunction, with motor deficits reported in up to 94% of patients and sensory deficits in up to 89%. ICD-10-CM G37. A generalized tonic-clinic seizure, characterized by loss of consciousness. 14 - other international versions of ICD-10 M32. Publication Date: June 2009 Implementation Date: 1/07/2020 Updated Date: 27/07/2021 ICD 10 AM Edition: Eleventh Edition. Code History. The following ICD-10-CM codes1 may be used to identify patient medical conditions typically associated with Privigen use. The 2024 edition of ICD-10-CM G61 became effective on October 1, 2023. BILLABLE | ICD-10 from 2011 - 2016. ICD-9-CM 357. G47. GAMUNEX-C is also approved to treat. G62. 29 may differ. 9 may differ. 3 Polyneuropathy in malignant disease convert 357. The following ICD-10 code has been added to the Group 2 codes as a covered diagnosis: G61. ICD-10 diagnosis code for hyperimmunoglobulin E (IgE) syndrome. This revision is due to the Annual ICD-10-CM Update and will become effective on 10/1/22. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). 8; ICD-11: 8C01. 117. About 20% of patients end up with respiratory failure. 9% in PATH. Different electrophysiological profiles and treatment response in “typical” and “atypical” chronic inflammatory demyelinating polyneuropathy. ICD-10; Gene name or symbol; Other search option(s) Alphabetical list; Suggest an update. 2% of mean total costs. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM. 2: Common variable immunodeficiency with autoantibodies to B- or. 00 Multiple myeloma not having achieved remission C88. com is a free reference website designed for the fast lookup of all current American ICD-10-CM (diagnosis) and ICD-10-PCS (procedure) medical billing codes. The 2024 edition of ICD-10-CM I63. LCD is revised to add diagnosis G61. Summary. G61. with oculomotor and/or bulbar symptoms. CMS publishes and maintains the HCPCS code set. 0 Acute infective polyneuritis convert 357. 42 Type 2 diabetes mellitus with diabetic polyneuropathy. 1 Serum neuropathy. (2087) 22 or/19‐21 (3331) 23 plasma exchange. 14 may differ. Diseases of the nervous system. Background. We reviewed the literature on chronic inflammatory demyelinating polyneuropathy (CIDP) in diabetes mellitus (DM) and explored real-world data on the prevalence and treatment of CIDP within DM. All codes listed in this guide are for. 81 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 357. The main part of the nerve that is attacked is the insulating sheath, or myelin. DADS with M-protein (DADS-M) is less responsive to immunotherapy compared to those without M-protein (DADS-I). Im Gegensatz zur alten Klassifikation wurde der Begriff atypische CIDP durch den Begriff CIDP-Varianten ersetzt, mit der Begründung, dass es sich hierbei um nun gut charakterisierte Entitäten handele, die jeweils einem. Your message * (3000. However, patients with diabetes can also develop inflammatory neuropathies, the most common and most treatable of which is chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). "Our new test folds in our standalone NF155 test with a new cell-based assay for CNTN1. 1 Because of the lack of disease-specific diagnostic biomarkers, the diagnosis depends on combination of clinical, electrodiagnostic, and laboratory/neuroimaging findings, as well as exclusion criteria; and in clinical practice,. in 1999. The 2024 edition of ICD-10-CM Z91. What is ICD-10 for GBS? The ICD-10 Code for Guillain-Barré syndrome is G61. From time periods April 2000 to March 2001, 717 charts, and from April 2002 to March 2003, 249 charts. Results: In total, 3975 patients (median age 58 years) with CIDP who initiated IVIG were identified. All codes listed in this guide are for informational purposes and are not an exhaustive list. Applicable To. Adult IG-naïve patients with one or more recorded diagnosis codes for CIDP (International Classification of Diseases, 9th edition, clinical modification [ICD-9-CM] code 357. E11. Look-Ups. . This is the American ICD-10-CM version of G61. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Below are the ICD-10-CM 26 diagnosis codes that may be used to identify patient medical conditions typically associated with PI, CIDP, and chronic ITP. "Over time, two antibodies — NF155 and CNTN1 — have been validated to cause about 10% to 20% of all cases of CIDP," Dr. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code Z86. Get crucial instructions for accurate ICD-10-CM F15. Creation of Uniform LCDs Within a MAC Jurisdiction; Revisions Due To. Autonomic neuropathy in diseases classified elsewhere. Research criteria for diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP): report from an ad hoc subcommittee of the American Academy of Neurology AIDS Task Force. 52 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. However, further higher sensitivity would be ideal, and we suggest that particularly for patients who have suspectable CIDP and do not fulfil the electrodiagnostic criteria, the use of peripheral nerve imaging with ultrasound and/or MRI, which was not widely performed in the. Guillain-Barre syndrome (GBS) is a syndrome with several variants, with acute inflammatory demyelinating polyneuropathy (AIDP), being the most. Seru. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is the most common chronic inflammatory neuropathy. Distal symmetric polyneuropathy (DSPN) is the most common neuropathy to occur in diabetes mellitus. Diagnosis relies on clinical and electrophysiological criteria. In an autoimmune disease, the body attacks its own tissues. -); gout (M1A. 9 may differ. ICD-10-CM Code G61. G62. 9 - other international versions of ICD-10 G61. Because of the similarities with symptoms of other disorders, it can take several months to obtain an accurate diagnosis of CIDP. 89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Chronic inflammatory demyelinating polyneuropathy. Purchase access. 9 is a billable diagnosis code used to specify polyneuropathy, unspecified. Polyneuropathy, unspecified. To code a diagnosis of this type, you must use one of the two child codes of G61. 2 to ICD-10-CM; 357. G62. 81. 12 may differ. G61. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 851 is applicable to maternity patients. O99. 8 Other inflammatory polyneuropathies. 9 is a valid billable ICD-10 diagnosis code for Demyelinating disease of central nervous system, unspecified . ICD-9-CM 357. Chronic inflammatory demyelinating polyneuritis. 9 may differ. CIDP is probably an autoimmune disease, ie one in which the immune system attacks its own body. ICD 10 code for Personal history of diseases of the nervous system and sense organs. The 2024 edition of ICD-10-CM G61. This is the American ICD-10-CM version of D57. G61. 5 mg venlafaxine. 4 Polyneuropathy in other diseases classified elsewhere convert 357. G61. This was the first year ICD-10-CM was implemented into the HIPAA code set. CTV3 codelist for chronic inflammatory demyelinating polyneuropathy (no corresponding ICD-10 codes found) Methodology. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10. The treating physician is solely responsible for diagnosis coding and determination of the appropriate ICD-10-CM codes that describe the patient's condition and are supported by the medical record. 81 is a billable ICD code used to specify a diagnosis of chronic. 1 may differ. 3 to ICD-10-CM; 357. Search All ICD-10 Toggle Dropdown. B. [1] The disorder is sometimes called chronic relapsing polyneuropathy ( CRP) or chronic inflammatory demyelinating. 81 is a valid billable diagnosis code for chronic inflammatory demyelinating polyneuropathy (CIDP), a condition that causes nerve damage and pain. 8 to 8. Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neurological disorder -- a condition that targets your body’s nerves. Neurology. 2. 8 that describes the diagnosis 'other inflammatory polyneuropathies' in more detail. Chronic inflammatory demyelinating polyneuropathy (CIDP) finally got its name in 1982. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10. DOI: 10. The JFA (L34092) LCD is retired and is combined into the JFB (L34074) LCD so that both JFA and JFB contract numbers will have the same final MCD LCD number. The 2024 edition of ICD-10-CM D80. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. ICD-10-CM code G61. 1 was deleted from Group 1 under "ICD-10 Codes that Support Medical Necessity. 29 - other international versions of ICD-10 G71. G37. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10. Distal symmetric polyneuropathy (DSPN) is the most common neuropathy to occur in diabetes mellitus. The following code (s) above G61 contain annotation back-references that may be applicable to G61 : G00-G99. 3 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Z79. CIDP synonyms, CIDP pronunciation, CIDP translation, English dictionary definition of CIDP. 2 Selective deficiency of immunoglobulin A [IgA] D80. 81 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 357. This is the American ICD-10-CM version of G62. Alcoholic polyneuropathy. 4 became effective on October 1, 2023. To read the full article, sign in and subscribe to AHA Coding Clinic ® for ICD-10-CM and ICD-10-PCS . ICD-10-CM Coding Rules. This section shows you chapter-specific coding guidelines to increase your understanding and correct usage of the target ICD-10-CM Volume 1 code. 9 coding with all applicable Excludes 1 and Excludes 2 notes from the section level conveniently shown with each code. Our purpose was to compare hospital discharge abstract coding using ICD-9 and ICD-10 for stroke and its risk factors. G61. D69. 43. This was the first year ICD-10-CM was implemented into the HIPAA code set. Summary of CIDP variants and their treatment. 12 became effective on October 1, 2023. were among the first to describe criteria for the diagnosis of CIDP, which included aspects of the clinical course (≥8 weeks’ progressive weakness and other symptoms); the type of nerve fiber class affected (large nerve fibers) and the symmetry of distribution. Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neurological disorder that involves progressive weakness and reduced senses in the. ICD-10-CM Codes. Electromyography (EMG) and Nerve conduction studies (NCS) are depicted in Tables Tables1 1- -4. Acute. Dubey says. 89 might also be used to specify conditions or terms like acute inflammatory demyelinating polyneuropathy or subacute inflammatory demyelinating polyradiculoneuropathy. 819 : G00-G99. doi: 10. Drug-induced polyneuropathy. 1 is a billable diagnosis code used to specify a medical diagnosis of sequelae of other inflammatory polyneuropathy. G61. 1, D81. With treatment. Code History. Various disorders requiring specific treatment regimens may be associated with CIDP, including sarcoidosis (SAR-CIDP) and connective tissue disease. Whether diabetes is a risk factor for CIDP. Activity:ICD-10 codes for this scenario would be: E11. G61. 8Other inflammatory polyneuropathies. The clinical presentation of. 8 Other inflammatory polyneuropathies. Important cost drivers were costs for outpatient ancillary, radiology and HCPCS drugs (mean $76,366 vs. Inflammatory polyneuropathy (G61) G60. 8 may differ. Applicable To. " These revisions are due to the Annual ICD-10 Updates effective 10/01/2020. 0000000000000907. , describes Mayo Clinic Laboratories' new diagnostic test for CIDP, or chronic inflammatory demyelinating polyneuropathy. 81 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 1 is applicable to male patients. Overall, atypical CIDP responds to treatment with first-line IMT, but has a suboptimal response compared to CIDP. 81 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 357. 0 Pre-ICD10 counterpart: Guillain–Barré syndrome: Charlson/ALERT Scale: none APACHE Como Component: none APACHE Acute Component: none Start Date: Stop Date: External ICD10 Documentation: ICD-10 CM Wikipedia; ICD-10. 9 may differ. Results At study inclusion, 124 (37. 3 HCPCS,4. The availability of International Classification of Diseases (ICD), Ninth Revision (ICD-9) or ICD-10 codes for CIDP will help identify patients with CIDP and will provide an opportunity for health plans to look at their own data regarding typical treatment patterns for CIDP and the related cost of care. 82, effective 10/1/2016 per the 2016/2017 annual ICD-10 update. The disorder is sometimes called chronic relapsing polyneuropathy (CRP) or chronic inflammatory demyelinating. ICD-10-CM Coding Rules. 8 is a new 2024 ICD-10-CM code that became effective on October 1, 2023. 521 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM R48.