Patient presents with persistent persecutory delusions, consistent with a diagnosis of Paranoia (ICD-10 code F22.0).  The patient exhibits a pervasive distrust and suspiciousness of others, interpreting their motives as malevolent.  Chief complaint includes the belief that they are being spied on, followed, or plotted against, despite a lack of objective evidence.  These delusions are fixed, non-bizarre, and have been present for [duration].  The patient's mental status examination reveals intact cognitive function with no evidence of hallucinations, disorganized speech, or grossly disorganized behavior.  Differential diagnoses considered include delusional disorder, persecutory type, schizophrenia, paranoid personality disorder, and substance-induced psychotic disorder.  Assessment indicates paranoia is the primary diagnosis due to the absence of other psychotic symptoms and the chronicity of the persecutory delusions.  The patient's current presentation does not meet criteria for involuntary hospitalization.  Treatment plan includes initiating antipsychotic medication, specifically [medication name and dosage], and referral to outpatient psychotherapy for individual therapy focused on cognitive behavioral therapy (CBT) techniques to address delusional thinking.  Prognosis is guarded, with ongoing monitoring and medication management crucial for symptom control and improved functioning.  Patient education provided regarding medication side effects, adherence, and the importance of follow-up appointments.  Medical billing codes will include CPT codes for psychiatric diagnostic evaluation and medication management, in addition to the ICD-10 code for paranoia.  Future documentation will focus on treatment response, medication adherence, and any changes in symptom presentation.