A 60-year-old male presents at the ER. He is homeless and has elevated glucose and a large goiter. Ultrasound of the thyroid is performed. There is a cystic mass in the right lobe in addition to the goiter. The ER doctor calls in an endocrinologist for a consult. The endocrinologist performs an ultrasound-guided thyroid biopsy. A decision for surgery is made. Code for the ER doc, the endocrinologist, the hospital, and the radiologist. Medicaid requires a second option. The ER doc consults a general surgeon who performs a consultation and reports a decision for surgery. Code for this physician as well.