Patient presents with complaints consistent with possible malignant mesothelioma.  Symptoms include progressively worsening dyspnea, persistent cough, and chest pain, potentially indicative of pleural mesothelioma.  The patient also reports fatigue, weight loss, and night sweats.  Physical examination revealed decreased breath sounds and dullness to percussion.  Occupational history includes extensive asbestos exposure during employment as a shipyard worker from 1970 to 1995, a significant risk factor for asbestos-related mesothelioma.  Differential diagnosis includes lung cancer, pleural effusion of other etiologies, and sarcomatoid mesothelioma.  Imaging studies, including chest x-ray and CT scan of the chest, abdomen, and pelvis, were ordered to assess the extent of pleural thickening and potential metastasis.  Thoracoscopy with pleural biopsy is scheduled to obtain tissue for histopathological confirmation of mesothelioma diagnosis and subtype determination (epithelioid, sarcomatoid, or biphasic).  Pulmonary function tests will be conducted to evaluate respiratory compromise.  Based on the clinical presentation, occupational history, and preliminary imaging findings, mesothelioma is a high clinical suspicion.  Further diagnostic evaluation and staging are necessary to determine the best course of treatment, which may include surgery (pleurectomydecortication, extrapleural pneumonectomy), chemotherapy (pemetrexed, cisplatin), radiation therapy, or a combination of these modalities.  Patient education regarding mesothelioma prognosis, treatment options, palliative care, and clinical trials was initiated.  Referral to oncology and pulmonology specialists has been made.  Follow-up appointment scheduled to discuss biopsy results and formulate a comprehensive treatment plan.  ICD-10 code C45.0 will be used pending biopsy confirmation.  Medical billing codes will be determined based on the specific procedures performed and treatment modalities utilized.