Patient presents with epiphora, commonly known as watery eye.  The chief complaint is excessive tearing, which may be constant or intermittent.  Onset of symptoms is documented, along with any associated symptoms such as ocular discharge, redness, itching, foreign body sensation, pain, photophobia, blurred vision, or double vision.  Assessment includes evaluation of tear drainage, including patency of the puncta and canaliculi, and observation for any eyelid malposition such as ectropion or entropion.  Nasolacrimal duct obstruction is considered in the differential diagnosis.  The patient's medical history, including allergies, prior eye surgeries or trauma, and current medications, is reviewed.  Examination reveals clear or mucoid discharge.  The cause of the epiphora is determined to be [specify cause e.g., reflex tearing due to dry eye, punctal stenosis, nasolacrimal duct obstruction, etc.]. Treatment plan includes [specify treatment e.g., artificial tears for dry eye, warm compresses and massage for nasolacrimal duct obstruction, referral to ophthalmology for punctal dilation or dacryocystorhinostomy, etc.]. Patient education provided regarding the condition, treatment options, and expected outcomes.  Follow-up appointment scheduled as needed. Coding considerations include ICD-10 code H04.23 (Epiphora) and relevant CPT codes for procedures performed, such as probing of the nasolacrimal duct (68820).  Medical billing documentation reflects the complexity of the evaluation and management services provided.