Patient presents with signs and symptoms suggestive of Wilms tumor, also known as nephroblastoma.  Chief complaints may include abdominal mass, palpable kidney, abdominal pain, hematuria, hypertension, and or anemia.  On physical examination, an abdominal mass may be palpable, firm, smooth, and non-tender, typically unilateral.  Diagnostic workup includes abdominal ultrasound, CT scan of the abdomen and chest, and complete blood count (CBC) with differential to evaluate for anemia and assess overall health.  Urine analysis may reveal hematuria.  Metastatic workup includes chest imaging to assess for lung metastases.  Based on imaging and clinical findings, the patient is diagnosed with Wilms tumor, stage (I, II, III, IV, or V) based on the extent of disease.  Differential diagnosis includes neuroblastoma, renal cell carcinoma, and other retroperitoneal masses.  Treatment plan includes referral to a pediatric oncologist for multidisciplinary management, which may involve nephrectomy, chemotherapy, and or radiation therapy depending on the stage and histology of the tumor.  Genetic counseling may be considered.  Patient education regarding the diagnosis, treatment options, and potential side effects is provided.  Follow-up care includes regular monitoring for recurrence and management of long-term complications.  ICD-10 code C61 (malignant neoplasm of kidney, except renal pelvis) is documented for medical billing and coding purposes.  This documentation supports medical necessity for the procedures and treatments rendered.