Patient presents with complaints consistent with hemorrhoids.  Symptoms include rectal bleeding, itching, pain, prolapse, and discomfort.  Onset of symptoms is reported as [duration].  Patient describes the bleeding as [bright red or dark] and associated with [bowel movements or other activities].  Pain is characterized as [sharp, dull, burning, throbbing] and located [internal, external, perianal].  The patient denies any fever, chills, or changes in bowel habits other than the reported bleeding.  Physical examination reveals [internal hemorrhoids, external hemorrhoids, thrombosed hemorrhoids] at [clock positions if applicable].  The affected area appears [edematous, erythematous, inflamed].  Digital rectal examination [was performed, was not performed due to patient discomfort] and revealed [findings, if performed].  Differential diagnoses considered include anal fissure, fistula, and rectal prolapse.  Diagnosis of hemorrhoids is made based on patient symptoms and physical examination findings.  Treatment plan includes [conservative management with high-fiber diet, increased fluid intake, sitz baths, topical creams or ointments containing hydrocortisone or lidocaine, stool softeners] or [minimally invasive procedures such as rubber band ligation, sclerotherapy, infrared coagulation] or [surgical intervention such as hemorrhoidectomy, depending on the severity and patient preference].  Patient education provided on proper hygiene, dietary modifications, and preventative measures.  Follow-up scheduled in [ timeframe] to assess response to treatment and discuss further management options if necessary.  ICD-10 code [appropriate code, e.g., I84.1 for internal hemorrhoids without complication] is applied.  CPT codes for procedures, if performed, will be documented separately.