Patient presents with symptoms consistent with sundowning syndrome, also known as late-day confusion.  The patient exhibits increased confusion, agitation, anxiety, and restlessness in the late afternoon and evening hours.  These symptoms are temporally related to the diurnal cycle and worsen as daylight diminishes.  The patient's baseline cognitive function is documented as (insert baseline cognitive status - e.g., mild cognitive impairment, dementia, etc.).  Differential diagnoses considered include delirium, medication side effects, and sleep disturbances.  Assessment included a review of medications, cognitive assessment using (specify assessment tool - e.g., Mini-Mental State Examination, Montreal Cognitive Assessment), and discussion with family or caregivers regarding behavioral changes.  Current medications were reviewed for potential exacerbating factors.  The patient's environment was assessed for safety concerns related to increased confusion and agitation.  Plan of care includes non-pharmacological interventions such as establishing a regular routine, optimizing lighting, and providing a calming environment in the evening.  Patient and family education provided on sundowning syndrome, its management, and available support resources.  Follow-up scheduled to assess response to interventions and consider pharmacological management if non-pharmacological strategies prove insufficient.  ICD-10 code G30.1 (Alzheimer's disease with late onset) or F02.81 (Dementia in other diseases classified elsewhere with behavioral disturbance) may be appropriate depending on the underlying etiology, along with appropriate modifiers if applicable for medical billing and coding purposes.  CPT codes for evaluation and management services will be determined based on the complexity of the visit.