Patient presents with macrocephaly, defined as head circumference greater than two standard deviations above the mean for age and sex.  Clinical evaluation for macrocephaly includes assessment of head growth velocity, family history of large head size, and developmental milestones.  Differential diagnosis for macrocephaly encompasses benign familial macrocephaly, hydrocephalus, megalencephaly, and intracranial pathology such as brain tumors or subdural hematomas.  Physical examination findings may include prominent forehead, wide fontanelles, or cranial nerve abnormalities.  Diagnostic testing may include head ultrasound, CT scan of the head, or MRI brain to evaluate for underlying causes of macrocephaly.  Treatment for macrocephaly depends on the underlying etiology.  If benign familial macrocephaly is suspected, reassurance and monitoring are appropriate.  Referral to a pediatric neurologist or neurosurgeon is indicated for suspected hydrocephalus, intracranial lesions, or other neurological concerns.  Genetic testing may be considered in cases of syndromic macrocephaly.  Medical billing and coding for macrocephaly utilizes ICD-10 codes such as Q75.3 (Congenital macrocephaly) or R59.0 (Localized swelling, mass, and lump, head).  CPT codes for diagnostic imaging and specialist consultations are also relevant depending on the specific procedures performed.  This documentation serves as a template for macrocephaly and should be tailored to individual patient presentations and clinical findings.  Continued monitoring and appropriate referrals are essential components of macrocephaly management.