Patient presents with symptoms suggestive of gluten intolerance, including abdominal pain, bloating, diarrhea, and fatigue.  These symptoms are reported to occur after ingestion of gluten-containing foods such as bread, pasta, and cereals.  Onset of symptoms is described as variable, occurring anywhere from minutes to hours after gluten exposure.  Patient denies bloody stools, vomiting, or significant weight loss.  Family history is negative for celiac disease.  Physical examination reveals mild abdominal tenderness on palpation but is otherwise unremarkable.  Differential diagnosis includes celiac disease, irritable bowel syndrome, and wheat allergy.  Initial laboratory workup, including a complete blood count (CBC) and comprehensive metabolic panel (CMP), is within normal limits.  Serologic testing for celiac disease (tissue transglutaminase IgA and anti-endomysial antibodies) is negative.  Given the negative celiac serology and absence of alarm symptoms, a diagnosis of non-celiac gluten sensitivity is suspected.  Patient education regarding gluten-free diet implementation, including food avoidance and label reading, was provided.  A follow-up appointment is scheduled in four weeks to assess symptom improvement and provide further dietary guidance.  The patient was advised to return sooner if symptoms worsen or new symptoms develop.  ICD-10 code K52.9 (Non-infective gastroenteritis and colitis, unspecified) and CPT codes for the evaluation and management services provided (e.g., 99213 for a level 3 established patient office visit) will be used for billing and coding purposes.  This plan is consistent with current medical guidelines for gluten intolerance management.