Patient presents with signs and symptoms suggestive of hyperchloremia, an electrolyte imbalance characterized by elevated chloride levels in the blood.  Presenting complaints may include lethargy, weakness, deep and rapid breathing (Kussmaul respirations), or altered mental status.  Relevant medical history includes potential contributing factors such as dehydration, renal failure, metabolic acidosis, hyperparathyroidism, or excessive intake of chloride-rich solutions.  Physical examination findings may reveal signs of dehydration such as dry mucous membranes or decreased skin turgor.  Laboratory results confirm elevated serum chloride concentration exceeding the normal reference range.  Differential diagnosis considers other electrolyte imbalances such as hypernatremia and conditions causing metabolic acidosis.  Diagnosis of hyperchloremia is based on the combination of clinical presentation, medical history, physical examination, and laboratory data.  Treatment plan focuses on addressing the underlying cause of the elevated chloride levels.  This may include intravenous fluid administration with hypotonic solutions, correcting acid-base imbalances, managing renal dysfunction, or adjusting medications.  Patient education emphasizes the importance of medication adherence, monitoring fluid intake, and recognizing signs of dehydration.  Follow-up care includes monitoring serum chloride levels and assessing clinical response to treatment.  ICD-10-CM code E87.7 may be appropriate for this encounter, and CPT codes for laboratory testing and therapeutic interventions will be documented based on the specific services provided.  This documentation supports medical necessity and accurate medical billing and coding for hyperchloremia management.