Patient presents with complaints consistent with menstrual irregularity, characterized by abnormal uterine bleeding.  The patient reports experiencing variations in cycle length, frequency, and flow.  Keywords relevant to this presentation include:  menstrual cycle changes, irregular periods, abnormal bleeding, oligomenorrhea, amenorrhea, menorrhagia, metrorrhagia, menometrorrhagia, polymenorrhea.  Differential diagnosis considerations include hormonal imbalances, polycystic ovary syndrome (PCOS), thyroid disorders, uterine fibroids, endometrial polyps, adenomyosis, and coagulation disorders.  Pertinent past medical history, surgical history, family history, and social history including menstrual history, age of menarche, lifestyle factors, and medication use were reviewed.  Physical examination, including pelvic exam, was performed.  Laboratory tests, including complete blood count (CBC), thyroid panel, and hormone levels (e.g., follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin), may be ordered to assess for underlying causes.  Imaging studies, such as pelvic ultrasound or transvaginal ultrasound, may be considered.  Current treatment plan includes patient education regarding menstrual cycle tracking, lifestyle modifications, and potential pharmacological interventions for cycle regulation such as hormonal contraceptives or other medications as indicated based on diagnostic findings.  Follow-up appointments will be scheduled to monitor symptom improvement and adjust treatment as necessary.  ICD-10 coding will be determined based on the specific type of menstrual irregularity identified.  Medical billing will reflect the evaluation and management (E M) services provided, as well as any procedures or laboratory tests performed.  This documentation is intended for electronic health record (EHR) use and adheres to clinical documentation improvement (CDI) best practices.