Understanding Delusions of Parasitosis (Ekbom Syndrome): This resource provides information on Delusional Parasitosis for healthcare professionals, covering clinical documentation, diagnosis codes, ICD-10 codes, medical coding, and differential diagnosis. Learn about symptoms, treatment options, and best practices for documenting Ekbom Syndrome in patient charts and medical records.
Also known as
Persistent delusional disorders
Includes various persistent delusional disorders, like parasitosis.
Schizophrenia, schizotypal and delusional disorders
Encompasses a range of psychotic disorders, including delusions.
Neurotic, stress-related and somatoform disorders
Includes disorders with physical symptoms but no underlying physical cause.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the primary diagnosis Delusions of Parasitosis?
Yes
Is there evidence of a true parasitic infestation?
No
Do NOT code F22. Code the appropriate diagnosis.
When to use each related code
| Description |
|---|
| Fixed belief of parasitic infestation without evidence. |
| Obsessive skin picking due to perceived infestation. |
| Somatic delusion involving non-parasitic bodily dysfunction. |
Using unspecified infestation codes (e.g., B88.9) instead of the specific code for Delusions of Parasitosis (F22.0) can lead to inaccurate reporting and reimbursement.
Insufficient documentation of co-existing mental health conditions alongside Delusions of Parasitosis can impact severity coding and risk adjustment.
Coding Delusions of Parasitosis as confirmed when it is being ruled out can lead to clinical documentation integrity issues and incorrect claims.
Q: How to differentiate Delusions of Parasitosis (Ekbom Syndrome) from actual parasitic infestations in clinical practice?
A: Differentiating Delusions of Parasitosis (Ekbom Syndrome) from a true infestation requires a thorough clinical approach. Begin with a detailed patient history, focusing on the specific sensations described, onset, and duration. Conduct a comprehensive physical exam, meticulously examining the skin, hair, and any presented samples. Negative laboratory findings, including skin scrapings, stool samples, and other relevant tests, despite persistent patient conviction, strongly suggest Delusions of Parasitosis. Consider the patient's psychiatric history, as comorbid conditions like anxiety or depression may be present. Explore how collaborative care with a dermatologist and a psychiatrist can ensure appropriate management. A sensitive approach, acknowledging the patient's distress while firmly explaining the absence of physical evidence, is crucial. Learn more about the diagnostic criteria for Delusions of Parasitosis to enhance your diagnostic accuracy.
Q: What are the most effective treatment strategies for patients presenting with Delusions of Parasitosis, considering both pharmacological and non-pharmacological approaches?
A: Treatment for Delusions of Parasitosis often requires a multifaceted approach. Pharmacologically, antipsychotic medications, particularly atypical antipsychotics like risperidone or olanzapine, can be effective in managing the delusional beliefs. However, patient resistance to accepting psychiatric medication is common. Building a strong therapeutic alliance and gently addressing the patient's concerns is essential. Non-pharmacological strategies include cognitive behavioral therapy (CBT) to help patients identify and challenge their delusional thoughts. Consider implementing a collaborative care model, involving dermatologists for initial evaluation and ruling out actual infestations, and psychiatrists for ongoing mental health management. Explore how a compassionate and empathetic approach, acknowledging the patient's suffering while reinforcing the absence of a parasitic infestation, can improve treatment adherence and outcomes.
Patient presents with a fixed, false belief of parasitic infestation, consistent with a diagnosis of Delusions of Parasitosis (also known as Ekbom Syndrome or Delusional Parasitosis). The patient reports sensations of crawling, biting, and stinging on the skin, often accompanied by the presentation of "specimens" that are typically skin debris, lint, or other environmental artifacts. These sensations and perceived evidence are not corroborated by physical examination or laboratory findings. Mental status examination reveals intact cognitive function except for the firmly held delusion. Differential diagnosis includes true parasitic infestations, scabies, allergic dermatitis, and other forms of somatic delusions. Rule-out of medical causes was conducted through skin scraping and examination, which were negative. Patient's history is negative for substance abuse and other psychiatric disorders that could explain the delusional beliefs. The patient's symptoms are causing significant distress and impairment in daily functioning, including social withdrawal and excessive self-treatment with over-the-counter remedies. Initial treatment plan includes establishing therapeutic rapport, psychoeducation about Delusions of Parasitosis, and consideration of a referral to psychiatry for possible antipsychotic medication, such as pimozide, and cognitive behavioral therapy (CBT) to address the delusional beliefs. Patient education materials on Delusions of Parasitosis and coping mechanisms were provided. Follow-up appointment scheduled to assess treatment response and symptom management. ICD-10 code F22 will be used for billing purposes.