Patient presents today for evaluation of latent tuberculosis infection (LTBI) following a positive QuantiFERON-TB Gold Plus test.  The patient reports no current symptoms of active tuberculosis (TB) such as fever, night sweats, cough, weight loss, or hemoptysis.  Physical examination reveals no abnormalities suggestive of active TB, including clear lung sounds and no lymphadenopathy.  Review of systems is negative for constitutional symptoms.  Past medical history is unremarkable for prior TB exposure, infection, or treatment.  Social history includes travel to a country with intermediate TB incidence within the last two years.  The positive QuantiFERON-TB Gold Plus result indicates likely infection with Mycobacterium tuberculosis.  Given the absence of symptoms and signs of active tuberculosis disease, the diagnosis is latent tuberculosis infection.  Chest X-ray is ordered to rule out active pulmonary tuberculosis.  Patient education was provided regarding the difference between latent and active TB, transmission risks, and the importance of adherence to treatment.  Treatment options for latent tuberculosis infection were discussed, including isoniazid (INH), rifampin (RIF), and rifapentine (RPT).  Risks and benefits of each regimen were reviewed.  Patient will follow up for repeat testing and initiation of LTBI treatment if chest x-ray is negative for active disease.  ICD-10 code R76.12, Latent tuberculosis infection confirmed by bacteriological or immunological methods, and appropriate CPT codes for the QuantiFERON test and subsequent chest x-ray will be documented.  Differential diagnosis includes other causes of granulomatous disease and false-positive QuantiFERON results.