Find information on Depression with Suicidal Ideation (SI), including Major Depressive Disorder with Suicidal Thoughts, for healthcare professionals. This resource covers clinical documentation, medical coding, and DSM-5 criteria related to Depression with SI. Learn about assessment, diagnosis, and treatment considerations for patients experiencing suicidal thoughts alongside major depression. Improve your understanding of Depression with Suicidal Thoughts and ensure accurate documentation for optimal patient care.
Also known as
Major depressive disorder
Covers various forms of depression, including those with suicidal thoughts.
Symptoms and signs involving appearance and behavior
Includes suicidal ideation as a symptom.
Personal history of suicidal behavior
Relevant for patients with a past history of suicidal attempts or ideation.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the patient's depression single or recurrent episode?
Single episode
Current suicidal ideation?
Recurrent episode
Current suicidal ideation?
When to use each related code
| Description |
|---|
| Depression with thoughts of suicide or self-harm. |
| Depression without suicidal thoughts. |
| Suicidal ideation without depression. |
Lack of documentation specifying active vs. passive SI, plan, and intent impacts accurate coding and risk assessment.
Overlooking or miscoding comorbid anxiety, PTSD, or substance use disorders can affect DRG assignment and reimbursement.
Insufficient documentation of depression severity (mild, moderate, severe) may lead to lower reimbursement and inaccurate quality reporting.
Q: What are the most effective evidence-based interventions for managing acute suicidal ideation in patients with major depressive disorder?
A: Managing acute suicidal ideation in patients with major depressive disorder requires a multi-faceted approach. Evidence-based interventions include immediate safety planning and risk assessment, considering hospitalization for high-risk individuals. Pharmacological interventions such as antidepressants, antipsychotics (e.g., quetiapine, risperidone), or lithium can be beneficial, with the choice depending on patient-specific factors. Psychotherapeutic interventions like Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Collaborative Assessment and Management of Suicidality (CAMS) have demonstrated efficacy. Explore how integrating these interventions can improve patient outcomes and consider implementing a collaborative care model involving psychiatrists, therapists, and other healthcare professionals. Learn more about the specific indications and contraindications for each medication and therapy when tailoring treatment plans for patients with depression and suicidal thoughts.
Q: How can clinicians differentiate between passive suicidal ideation and active suicidal ideation with intent and plan in a depressed patient?
A: Differentiating between passive and active suicidal ideation is crucial for effective risk assessment. Passive suicidal ideation involves thoughts of death or wishing to be dead without a specific plan or intent to act. Active suicidal ideation, however, includes thoughts of suicide accompanied by a plan, intent, and often preparation. Clinicians should conduct a thorough assessment by directly asking patients about the frequency, intensity, and duration of suicidal thoughts, exploring any existing plans, access to means, and previous suicide attempts. Observe for behavioral changes such as social withdrawal, giving away possessions, or sudden calmness after a period of distress. Consider implementing standardized assessment tools like the Columbia-Suicide Severity Rating Scale (C-SSRS) or the Beck Scale for Suicide Ideation (BSI) to enhance the accuracy of the assessment. Learn more about the clinical nuances of assessing suicidal ideation and explore training opportunities to develop proficiency in suicide risk assessment.
Patient presents with symptoms consistent with a diagnosis of Major Depressive Disorder with Suicidal Ideation (Depression with SI). The patient reports depressed mood, anhedonia, significant weight loss, insomnia, fatigue, feelings of worthlessness, and diminished concentration for the past several weeks. Critically, the patient endorses recurrent thoughts of death and suicidal ideation, though denies having a specific plan or intent to harm themselves at this time. Assessment includes evaluation for depression symptoms, suicidal thoughts, and risk factors using standardized scales such as the PHQ-9 and Columbia-Suicide Severity Rating Scale (C-SSRS). Differential diagnoses considered include adjustment disorder with depressed mood, bipolar disorder, and medical conditions that can mimic depression. Treatment plan includes initiation of antidepressant medication, referral to psychotherapy with a focus on cognitive behavioral therapy (CBT) and suicide safety planning, and close monitoring of suicidal ideation. Patient education provided on medication side effects, coping mechanisms, and crisis resources. The patient will follow up weekly for medication management and symptom assessment, with a focus on suicide prevention and mental health stabilization. ICD-10 code F32.9 (Major depressive disorder, single episode, unspecified) and F33.9 (Major depressive disorder, recurrent episode, unspecified) are being considered along with appropriate Z codes for suicidal ideation depending on further evaluation and confirmation of chronicity. Medical necessity for these services is documented and supports the intensity of care provided.