Patient presents with signs and symptoms suggestive of metastatic colon cancer.  Presenting complaints include [Insert specific patient complaints e.g., abdominal pain, change in bowel habits, rectal bleeding, weight loss, fatigue].  Physical examination reveals [Insert relevant physical exam findings e.g., abdominal tenderness, palpable mass, hepatomegaly].  Review of systems notable for [Insert pertinent positives and negatives from ROS].  Past medical history includes [Insert relevant past medical history including family history of colon cancer, inflammatory bowel disease, polyps].  Patient underwent colonoscopy on [Date] which revealed [Specific findings e.g., a mass in the [Location] colon].  Biopsy confirmed adenocarcinoma of the colon.  Imaging studies, including CT scan of the abdomen and pelvis and chest x-ray, demonstrate metastatic disease to the [Specify location of metastasis e.g., liver, lungs, peritoneum].  Laboratory findings include [Insert relevant lab values e.g., CEA level, CBC, liver function tests].  Diagnosis of stage IV metastatic colon cancer is established based on these findings.  Treatment plan includes discussion of systemic chemotherapy options such as [Specify regimens e.g., FOLFOX, FOLFIRI, CapeOX] and targeted therapy options depending on molecular profiling results including KRAS, NRAS, and BRAF mutation status.  Patient was also referred to oncology and surgical oncology for consideration of palliative surgery or radiation therapy depending on the extent of metastatic disease and overall performance status.  Risks and benefits of each treatment option were discussed with the patient.  Follow-up appointment scheduled in two weeks to discuss treatment plan and address any questions or concerns.  Patient education provided regarding colon cancer, metastasis, treatment options, potential side effects, and importance of adherence to the prescribed regimen.  Prognosis discussed with the patient and family.  Coding considerations include primary site colon cancer, ICD-10 code C18.-, and secondary metastatic sites with corresponding ICD-10 codes.  Medical billing will reflect evaluation and management services, diagnostic procedures, and treatment planning.