Patient presents with signs and symptoms suggestive of a thyroid disorder.  Presenting complaints include fatigue, weight changes unintentional weight gain or loss, changes in bowel habits constipation or diarrhea, temperature intolerance heat or cold intolerance, mood changes irritability, anxiety, or depression, sleep disturbances insomnia or hypersomnia, menstrual irregularities, and changes in hair or skin texture dryness, thinning hair, brittle nails.  Physical examination findings may include goiter, thyroid nodules, tachycardia or bradycardia, tremor, changes in reflexes, and exophthalmos.  Differential diagnosis includes hypothyroidism, hyperthyroidism, thyroiditis, and thyroid cancer.  Laboratory evaluation may include thyroid stimulating hormone TSH, free T4 free thyroxine, free T3 free triiodothyronine, thyroid peroxidase antibodies TPO antibodies, and thyroglobulin antibodies Tg antibodies.  Imaging studies such as thyroid ultrasound and radioactive iodine uptake RAIU scan may be indicated.  Diagnosis of thyroid disorder is based on clinical presentation, laboratory findings, and imaging results.  Treatment plan may include thyroid hormone replacement therapy levothyroxine for hypothyroidism, antithyroid medications methimazole or propylthiouracil for hyperthyroidism, radioactive iodine therapy, or surgery thyroidectomy.  Patient education includes discussion of medication management, lifestyle modifications, and potential complications.  Follow-up appointments are scheduled to monitor thyroid function and adjust treatment as needed.  Medical coding and billing will utilize appropriate ICD-10 codes for thyroid disorders such as E03.9, E05.9, or E06.9, depending on the specific diagnosis, and CPT codes for services rendered, such as 99213 for an office visit.  Documentation within the EHR system will adhere to established guidelines for clinical documentation improvement CDI.