Patient presents with signs and symptoms suggestive of chronic kidney disease (CKD).  Presenting complaints include fatigue, decreased urine output, swelling in the ankles and feet, and shortness of breath.  Relevant medical history includes hypertension, type 2 diabetes mellitus, and a family history of kidney failure.  Physical examination reveals elevated blood pressure and pitting edema in the lower extremities.  Laboratory findings demonstrate an elevated serum creatinine level, decreased glomerular filtration rate (GFR), and proteinuria.  Based on these findings, a diagnosis of chronic kidney disease stage [Insert Stage] is made.  Differential diagnoses considered include acute kidney injury (AKI), nephrotic syndrome, and glomerulonephritis.  Plan includes initiation of renoprotective therapy with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), management of comorbidities such as hypertension and diabetes, dietary counseling focusing on protein restriction and sodium reduction, and patient education regarding disease progression and renal replacement therapy options like dialysis or kidney transplant.  Follow-up is scheduled to monitor renal function, electrolyte levels, and blood pressure control.  ICD-10 code N18. [Insert appropriate 5th character for stage of CKD] assigned.  Medical billing codes will reflect evaluation and management (E/M) services, laboratory testing, and prescribed medications.