We usually do not bubble and highlight the ICD manual. However I did put a few notes and bubbles in the index. If you can pinpoint the correct entry in the ICD10 index you will most likely be able to get the right code. For example, I put a bubble around the family history codes portion of the index in one color, and another color around the personal history entries. In the External Cause Index, I have bubbles around some of the more lengthy topics such as Accident / bus occupant, car occupant, motorcyclist, and pedal cyclist. I have a different color bubble for Accudent, transport, pedestrian because it goes on for 8 + columns. "Burn, extent" was another place that I used a bubble, so I could find that entry more easily. The idea is to help yourself where you need it. So as you study and do practice questions, if something is a little hard to find, do your bubbling/ highlighting so that you can find it more easily next time you need it.