Patient presents with complaints consistent with a pilonidal cyst and abscess.  Symptoms include pain, swelling, erythema, and tenderness in the sacrococcygeal region.  Possible purulent drainage or foul odor may be noted.  On examination, a palpable fluctuant mass is identified in the natal cleft, suggestive of a pilonidal abscess formation secondary to a pilonidal cyst.  The patient reports experiencing discomfort, particularly with sitting and movement.  Differential diagnosis includes furuncle, carbuncle, hidradenitis suppurativa, and perianal abscess.  The diagnosis of pilonidal cyst with abscess is made based on clinical presentation and physical examination findings.  Treatment options, including incision and drainage, antibiotics, and potential excision of the pilonidal cyst and sinus tracts, were discussed with the patient.  Risks and benefits of each procedure were explained. The patient's medical history, surgical history, and current medications were reviewed.  Patient education provided on wound care, follow-up appointments, and potential complications such as recurrence and infection.  ICD-10 code L05.01 (Pilonidal cyst with abscess) is documented for this encounter.  CPT codes for procedures performed, such as incision and drainage (e.g., 10060, 10061) or excision (e.g., 11770, 11772), will be documented upon completion of the procedure.  Follow-up care instructions provided, including pain management, hygiene practices, and signs of potential complications to monitor for.