Patient presents with symptoms consistent with premenstrual syndrome (PMS).  The patient reports experiencing cyclical premenstrual symptoms that begin approximately one week prior to menses onset and resolve shortly after menstruation begins.  Reported symptoms include mood swings, irritability, anxiety, emotional lability, breast tenderness, bloating, fatigue, and food cravings.  These symptoms significantly impact the patient's daily activities and quality of life.  The patient denies any other significant medical history or current medications.  Physical examination is unremarkable.  Diagnosis of premenstrual syndrome (PMS) is made based on patient history and symptom presentation, meeting the American College of Obstetricians and Gynecologists (ACOG) criteria for premenstrual dysphoric disorder (PMDD) diagnostic criteria were considered but not fully met.  Differential diagnoses include thyroid disorders, other hormonal imbalances, and psychiatric conditions.  Initial management includes lifestyle modifications such as regular exercise, stress reduction techniques, and dietary adjustments.  Patient education provided on premenstrual syndrome (PMS) management, including symptom tracking and potential treatment options.  Follow-up scheduled in one month to assess symptom improvement and discuss further management strategies if needed.  ICD-10 code N94.3 assigned.  Keywords: premenstrual syndrome, PMS, premenstrual dysphoric disorder, PMDD, menstrual cycle, mood swings, irritability, anxiety, bloating, fatigue, treatment, diagnosis, ACOG, ICD-10, N94.3, lifestyle modifications, patient education, clinical documentation, medical billing, coding.