As a current student studying medical office administration and medical coding, having my own copy of the icd-9-cm has been invaluable. my school offers free use of previous editions during the semester, but making notes in the margin, etc. is prohibited inside school-owned manuals. i have previous employment experience working with the ingenix version of icd-9-cm, and choosing to purchase the ama-published version was simple. i was able to preview the 2011 ama icd-9-cm (non spiral-bound) at my college bookstore and found the included netter's anatomy to serve as an excellent reference. the layout is easy to follow and page corner markings clearly alert the coder to each page's contents. color-coding throughout makes locating chapters, tips, symbols, and other indicators very simple. i prefer a spiral-bound edition over traditional paperback binding because spiral binding allows this large book to lay flat when open, which is essential for frequent use. i have used this edition for approximately one month and am completely satisfied with my choice to purchase the ama version.