Patient presents with a prosthetic aortic valve, confirmed by echocardiogram demonstrating a bioprosthetic or mechanical valve in the aortic position.  The indication for aortic valve replacement was [Specify original indication e.g., severe aortic stenosis, aortic regurgitation, infective endocarditis].  Current symptoms include [Document patient's presenting symptoms e.g., dyspnea, chest pain, syncope, palpitations, heart failure symptoms].  Physical examination reveals [Document relevant findings e.g., heart rate, rhythm, murmur, presence or absence of click, jugular venous pressure, peripheral edema].  Patient is currently managed with [List medications e.g., warfarin, antiplatelet therapy, heart failure medications].  Plan includes ongoing monitoring for prosthetic valve dysfunction, including thromboembolism, endocarditis, structural valve deterioration, and hemolytic anemia.  Patient education provided regarding medication adherence, signs and symptoms of complications, and the need for regular follow-up.  Aortic valve replacement surgery date: [Date of surgery].  Type of prosthetic valve: [Specify bioprosthetic tissue valve or mechanical valve].  Anticoagulation status: [Specify therapeutic INR range if on warfarin, or antiplatelet regimen].  Follow-up echocardiogram scheduled to assess prosthetic valve function and hemodynamics.  Differential diagnosis at the time of aortic valve replacement included [List relevant differential diagnoses considered prior to the original valve replacement].  ICD-10 code: Z95.5 (Presence of prosthetic heart valve).  CPT codes for today's visit will be determined based on the evaluation and management services provided.