Patient presents with Major Neurocognitive Disorder (MND) with Behavioral Disturbance (DSM-5 294.1) characterized by a significant decline in cognitive function interfering with independence in daily activities.  The cognitive decline is not attributable to delirium and does not occur exclusively in the context of a major or mild neurocognitive disorder with Lewy bodies.  The behavioral disturbance manifests as clinically significant agitation, aggression, apathy, disinhibition, aberrant motor behavior, or other neuropsychiatric symptoms impacting functional capacity.  Onset and progression of cognitive decline were confirmed by patient report, collateral history from family, and objective neuropsychological testing revealing deficits in one or more cognitive domains (e.g., complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition).  Differential diagnoses considered included Alzheimer's disease, frontotemporal dementia, vascular dementia, and other neurodegenerative conditions.  Current symptoms include increased irritability, verbal outbursts, and resistance to care.  These behavioral disturbances contribute to caregiver burden and safety concerns.  Pharmacological interventions are being considered to manage behavioral symptoms, alongside non-pharmacological approaches such as environmental modifications and behavioral therapy.  Caregiver education and support are crucial components of the treatment plan.  Prognosis, disease course, and potential complications were discussed with the patient and family.  Follow-up appointments are scheduled to monitor disease progression, assess treatment efficacy, and adjust the care plan as needed.  ICD-10 code F02.81 is assigned for Major Neurocognitive Disorder, Probable Alzheimer's disease with behavioral disturbance.  CPT codes for evaluation and management services, neuropsychological testing, and pharmacologic management will be billed accordingly.