Patient presents with symptoms consistent with a lower respiratory tract infection (LRTI).  Chief complaints include productive cough, dyspnea, and chest tightness.  Onset of symptoms began approximately three days ago and has progressively worsened.  Patient reports fever with chills, malaise, and decreased appetite.  Physical exam reveals rhonchi and wheezing on auscultation, with increased respiratory rate and effort.  Oxygen saturation is 94% on room air.  Differential diagnosis includes bronchitis, pneumonia, and bronchiolitis.  Preliminary diagnosis of acute bronchitis is made based on clinical presentation.  Treatment plan includes symptomatic relief with over-the-counter cough suppressants, expectorants, and antipyretics.  Patient education provided on the importance of hydration, rest, and avoiding irritants.  Follow-up recommended in one week to assess symptom resolution.  If symptoms worsen or no improvement is observed, further investigation with chest x-ray and laboratory studies may be warranted to rule out pneumonia or other lower respiratory infections.  Medical coding will be dependent on the final diagnosis and may include J20.9 for acute bronchitis, J18.9 for pneumonia, unspecified organism, or J21.9 for acute bronchiolitis, unspecified.  Billing codes will reflect the evaluation and management services provided, along with any diagnostic testing or procedures performed.  Patient advised to return if symptoms of shortness of breath worsen or if high fever develops.