Patient presents with complaints consistent with peripheral neuropathy in feet, characterized by symptoms of numbness, tingling, burning pain, and or pins and needles sensations in the bilateral lower extremities.  Onset of symptoms is reported as gradual progressive over the past six months. Patient denies any recent trauma, infection, or known exposure to toxins.  Medical history significant for type 2 diabetes mellitus, diagnosed five years ago, currently managed with metformin.  Family history is positive for diabetes and hypertension.  Physical examination reveals decreased sensation to light touch and pinprick in the distal lower extremities, extending to the mid-foot bilaterally.  Ankle reflexes are diminished.  Vibratory sensation is reduced in the toes.  Assessment:  Peripheral neuropathy, likely diabetic neuropathy, affecting bilateral feet.  Plan:  Order Hemoglobin A1c, comprehensive metabolic panel, and vitamin B12 levels to assess for underlying metabolic or nutritional deficiencies.  Educate patient on proper foot care including daily inspection, appropriate footwear, and avoidance of extreme temperatures.  Discuss the importance of optimizing blood glucose control to prevent further progression of neuropathy.  Consider initiating treatment with gabapentin or pregabalin for symptomatic relief of neuropathic pain, pending lab results.  Referral to podiatry for ongoing foot care and evaluation for custom orthotics will be considered.  Follow-up scheduled in four weeks to reassess symptoms and review lab findings.  Differential diagnoses considered include alcoholic neuropathy, vitamin deficiency neuropathy, and chemotherapy-induced peripheral neuropathy but were deemed less likely based on the patient's history and presentation.  ICD-10 code G63.2, Diabetic polyneuropathy, and CPT codes 99214 for level 4 established patient office visit and 95004 for sensory nerve conduction study will be billed, pending completion of nerve conduction study at a subsequent visit.