Patient presents with concerns regarding large uterine window identified on recent hysterosalpingogram HSG.  The patient reports  (insert relevant symptoms e.g., infertility, abnormal uterine bleeding, recurrent pregnancy loss).  Past medical history includes (list relevant medical history e.g., prior uterine surgery, cesarean section, endometriosis, pelvic inflammatory disease).  Menstrual history is significant for (describe menstrual cycle characteristics e.g., regular, irregular, heavy, light, painful).  Physical examination reveals (document pelvic exam findings e.g., normal uterine size and shape, tenderness).  Hysterosalpingogram findings demonstrate a large uterine window measuring (insert measurement) consistent with the diagnosis of large uterine isthmocele uterine defect.  Differential diagnoses considered include bicornuate uterus and septate uterus.  Plan of care includes discussion of risks and benefits of surgical correction of the uterine window isthmocele via hysteroscopic metroplasty.  Patient education provided regarding potential complications of surgery, postoperative recovery, and impact on future fertility.  Patient to schedule a follow-up appointment to discuss treatment options and address any further questions.  ICD-10 code N85.8 other specified noninflammatory disorders of uterus will be used for billing purposes.  CPT codes for potential procedures such as 58555 hysteroscopy surgical; with dilation and curettage D and C and 58563 hysteroscopy surgical; resection of uterine septum, wall, or fibroid will be determined based on the chosen surgical approach if applicable.