Patient presents with hypertension associated with diabetes mellitus.  The patient's documented history includes type 2 diabetes controlled with metformin and lifestyle modifications.  Current blood pressure readings consistently exceed 13080 mmHg, meeting the diagnostic criteria for hypertension.  Assessment reveals no evidence of secondary hypertension.  Laboratory results indicate normal renal function and potassium levels.  The patient reports no symptoms directly attributable to elevated blood pressure, such as headaches or dizziness.  The patient understands the increased cardiovascular risk associated with comorbid hypertension and diabetes.  The plan includes initiating antihypertensive therapy with lisinopril, a recommended first-line agent for patients with diabetes.  Patient education emphasizes lifestyle modifications including dietary sodium restriction, weight management, and regular exercise.  Follow-up appointment scheduled in four weeks to monitor blood pressure response to therapy and assess for potential adverse effects.  ICD-10 codes assigned are E11.9 for type 2 diabetes mellitus without complications and I10 for essential primary hypertension.  Medical billing will reflect evaluation and management services for a patient with established diabetes and newly diagnosed hypertension.  Differential diagnoses considered included renal artery stenosis and sleep apnea, which were ruled out based on clinical findings and patient history.  Patient counseling addressed medication adherence and the importance of blood pressure control in mitigating long-term diabetic complications such as nephropathy and retinopathy.  Emphasis was placed on shared decision-making regarding treatment options and the patient expressed understanding of the plan of care.