Patient presents with suspected hepatic steatosis, also known as fatty liver disease.  Clinical findings suggest nonalcoholic fatty liver disease (NAFLD) as the most likely etiology, given the absence of significant alcohol consumption reported.  The patient denies excessive alcohol intake, defined as more than two drinks per day for men and one drink per day for women.  Relevant symptoms include fatigue and right upper quadrant abdominal discomfort.  Physical examination revealed mild hepatomegaly.  Laboratory results show elevated liver enzymes, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST), with an ASTALT ratio less than 1.  Imaging studies, including an abdominal ultrasound, demonstrate increased echogenicity consistent with fatty infiltration of the liver.  Differential diagnoses considered include alcoholic fatty liver disease (AFLD), hepatitis, and metabolic syndrome.  Given the patient's history and clinical picture, NAFLD is the primary diagnosis.  Treatment plan focuses on lifestyle modifications, including weight loss through diet and exercise, to address the underlying metabolic dysfunction.  Patient education regarding the importance of a healthy diet, regular physical activity, and avoidance of hepatotoxic substances was provided.  Follow-up appointment scheduled to monitor liver enzyme levels and assess treatment response.  ICD-10 code K76.0, unspecified fatty liver, assigned.  CPT code 99213 for the established patient office visit with a low level of medical decision making is documented.  The patient demonstrates understanding of the diagnosis and treatment plan.