Left axis deviation (LAD) was noted on electrocardiogram (ECG, EKG).  The patient presents with (insert presenting symptoms, e.g., asymptomatic, palpitations, shortness of breath, syncope, chest pain, dizziness, fatigue).  ECG findings demonstrate a QRS axis greater than -30 degrees, consistent with the diagnostic criteria for left axis deviation.  Differential diagnoses considered include left anterior fascicular block, inferior myocardial infarction, left ventricular hypertrophy, and other conduction abnormalities.  Patient history includes (insert relevant medical history, e.g., hypertension, hypertrophic cardiomyopathy, prior myocardial infarction, congenital heart disease, conduction system disease).  Current medications include (list current medications).  Physical examination reveals (insert relevant physical exam findings, e.g., normal heart sounds, presence of murmurs, normal respiratory rate and effort).  Based on the patient's presentation, medical history, and ECG findings, the left axis deviation is likely (insert likely etiology, e.g., physiologic, secondary to left anterior fascicular block, secondary to left ventricular hypertrophy).  Plan includes (insert plan, e.g., further investigation with echocardiogram to assess cardiac structure and function, cardiology consultation, monitoring for symptom progression, no further intervention at this time if asymptomatic and etiology is benign).  ICD-10 code I44.4 (left bundle branch block) may be considered if applicable, depending on the underlying cause and ECG features; however, a more specific code reflecting the underlying etiology should be used if known.  This documentation supports medical billing and coding for appropriate reimbursement.  Patient education provided regarding left axis deviation, potential causes, and treatment plan.  Follow-up scheduled as needed.