Patient presents with symptoms consistent with onychomycosis, also known as toenail fungus.  Clinical findings include thickened, discolored (yellow, brown, or white), brittle, and possibly crumbling toenails. The patient reports [Insert patient's subjective complaints, e.g., nail thickening, discoloration, pain, foul odor, difficulty trimming nails].  Affected toenails are [Specify location, e.g., great toe, lesser toes, unilateral, bilateral].  The patient denies any recent trauma to the affected area.  Differential diagnoses considered include psoriasis, lichen planus, and traumatic nail dystrophy.  Based on clinical presentation, a diagnosis of distal subungual onychomycosis is made.  Treatment options discussed include topical antifungal medications such as ciclopirox nail lacquer or efinaconazole solution, oral antifungal medications such as terbinafine or itraconazole, and laser therapy.  Risks and benefits of each treatment option were explained.  Patient elected to begin treatment with [Specify chosen treatment].  Patient education provided regarding proper nail hygiene, including keeping nails trimmed short, dry, and clean.  Follow-up appointment scheduled in [Duration] to monitor treatment response and assess for any adverse effects.  ICD-10 code B35.1 is assigned for onychomycosis.  CPT codes for potential procedures, such as nail debridement (11720, 11721), were reviewed and will be applied if performed during subsequent visits.  Patient understands the diagnosis, treatment plan, and importance of adherence.