Patient presents with symptoms consistent with a diagnosis of Attention-Deficit Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Presentation (ADHD-HI).  Clinical interview and behavioral observations indicate significant functional impairment related to hyperactivity and impulsivity.  The patient demonstrates excessive motor activity, difficulty remaining seated in age-appropriate contexts, frequent fidgeting, and constant talking.  Impulsivity is evident in interrupting others, difficulty waiting their turn, and blurting out answers before questions are completed.  These symptoms have persisted for over six months and are present in multiple settings, including home and school, negatively impacting academic performance and social interactions.  DSM-5 diagnostic criteria for ADHD-HI are met.  Differential diagnoses considered include Oppositional Defiant Disorder and anxiety disorders, but the predominant and persistent symptoms of hyperactivity and impulsivity support the ADHD-HI diagnosis.  Treatment plan includes parent education regarding ADHD management strategies, behavioral therapy focusing on impulse control and self-regulation techniques, and consideration of pharmacotherapy with stimulant medication.  Referral to a psychiatrist specializing in ADHD is recommended for medication management if initiated.  Follow-up appointment scheduled in four weeks to assess treatment response and adjust the plan as needed.  ICD-10 code F90.0 is assigned for Attention-Deficit Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type.  CPT codes for evaluation and management services, as well as any psychological testing or therapeutic interventions, will be documented separately.  Keywords: ADHD, ADHD-HI, Attention Deficit Hyperactivity Disorder, hyperactivity, impulsivity, DSM-5, ICD-10 F90.0, CPT codes, diagnosis, treatment, medication, behavioral therapy, parent education, child behavior, attention deficit, mental health, psychiatric evaluation, electronic health record, medical billing, coding.