Patient presents with significant cognitive decline impacting independence in daily activities, consistent with a diagnosis of Major Neurocognitive Disorder (Major NCD).  The cognitive domains affected include memory (both short-term and long-term), executive function, and language.  Onset has been gradual, with progressive worsening observed over the past [timeframe, e.g., six months].  The decline is not attributable to delirium or another mental disorder.  Patient exhibits difficulties with [specific examples of functional impairment, e.g., managing finances, medication adherence, meal preparation].  Family reports [corroborating examples of cognitive decline and functional impairment, e.g., increased forgetfulness, difficulty with problem-solving, personality changes].  Neurological examination reveals [relevant findings, e.g., normal motor strength, intact reflexes, but evidence of impaired attention and memory].  Current medications include [list medications].  Differential diagnosis includes Alzheimer's disease, vascular dementia, frontotemporal dementia, and Lewy body dementia.  Further evaluation is planned to determine the underlying etiology, including neuropsychological testing, brain imaging (MRI or CT scan), and laboratory workup to rule out reversible causes.  Initial treatment plan focuses on managing symptoms, supporting caregivers, and optimizing safety.  Patient education regarding disease progression, community resources, and available support services was provided.  Referral to neurology and social work is made.  ICD-10 code F02.81 (Major neurocognitive disorder, unspecified) is provisionally assigned, pending further diagnostic clarification.  CPT codes for evaluation and management services (e.g., 99204, 99214) are documented based on time spent and complexity of medical decision-making.