Patient presents with symptoms suggestive of Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome.  Clinical findings include recurrent epistaxis, telangiectasias observed on the skin and mucous membranes, and a family history consistent with autosomal dominant inheritance.  The patient reports frequent nosebleeds, often requiring medical attention.  Mucocutaneous telangiectasias are evident on the lips, tongue, and fingers.  Pulmonary arteriovenous malformations (AVMs) are suspected and will require further imaging for confirmation.  Given the patient's presentation and family history, the Curacao criteria for HHT diagnosis are being considered.  Differential diagnoses include acquired vascular lesions and other inherited bleeding disorders.  A thorough evaluation is planned, including laboratory testing such as a complete blood count (CBC) to assess for anemia related to chronic blood loss, coagulation studies, and genetic testing for ENG, ACVRL1, and SMAD4 mutations to confirm the diagnosis of HHT.  Treatment planning will be based on the severity of symptoms and the presence of complications like AVMs.  Potential treatment options include medical management for epistaxis control, such as topical therapies, cauterization, or hormonal therapy.  Interventional radiology procedures may be necessary to address AVMs, if present.  Patient education regarding the genetic basis of HHT, symptom management, and the importance of regular follow-up care is essential.  ICD-10 code I78.1 will be used for billing purposes.  Referral to a specialized HHT center is being considered for comprehensive multidisciplinary management.  This documentation supports the medical necessity of diagnostic testing and treatment for Hereditary Hemorrhagic Telangiectasia.