Patient presents with signs and symptoms suggestive of lithium toxicity.  The patient's current lithium level is [insert value] mEqL.  Clinical presentation includes [list presenting symptoms e.g., tremor, nausea, vomiting, diarrhea, ataxia, confusion, lethargy, muscle weakness,  nystagmus, fasciculations,  altered mental status, seizures, coma].  The patient's reported lithium dosage is [insert dosage and frequency].  Onset of symptoms occurred [insert timeframe].  Patient's medication history includes [list medications] and relevant medical history includes [list medical conditions e.g., renal impairment, dehydration, sodium depletion].  Differential diagnoses considered include [list differential diagnoses e.g., drug interaction, serotonin syndrome, central nervous system infection].  Assessment points towards lithium toxicity based on elevated lithium level, correlating symptoms, and medication history.  Treatment plan includes discontinuation of lithium, supportive care including hydration with intravenous fluids, monitoring of electrolytes particularly sodium and creatinine, and close monitoring of neurological status.  If indicated, hemodialysis may be considered for severe toxicity with significantly elevated lithium levels or impaired renal function.  Patient education provided on lithium toxicity symptoms, importance of medication compliance, and regular monitoring of lithium levels.  Follow-up scheduled for [date and time] to reassess lithium level and clinical status.  ICD-10 code T36.1X5A, adverse effect of lithium, initial encounter, is documented.