Patient presents with noisy breathing (stridor, stertor, wheezing), prompting evaluation for potential respiratory distress.  Onset, duration, and character of the noisy breathing were documented, including any associated symptoms such as cough, dyspnea, cyanosis, or fever.  Assessment included auscultation of the lungs, evaluation of respiratory rate and effort, and observation for signs of respiratory distress.  Differential diagnosis considered upper airway obstruction (croup, foreign body aspiration, epiglottitis), lower airway obstruction (bronchiolitis, asthma, pneumonia), and other respiratory conditions (allergic reactions, vocal cord dysfunction).  Severity of noisy breathing was assessed and documented, ranging from mild to severe, impacting respiratory status.  Treatment plan may include oxygen therapy, nebulized medications, airway management, or further diagnostic testing such as chest x-ray or blood work.  Patient education provided on monitoring respiratory status, managing symptoms, and recognizing signs of worsening respiratory distress.  Follow-up care arranged as necessary, with appropriate referrals to specialists like pulmonology or otolaryngology if indicated.  Medical coding will reflect the specific diagnosis and procedures performed, utilizing appropriate ICD-10 and CPT codes for accurate billing and reimbursement.  Documentation supports medical necessity of interventions and facilitates communication among healthcare providers.