Patient presents with persistent pervasive distrust and suspiciousness of others, interpreting their motives as malevolent.  This presentation aligns with diagnostic criteria for Paranoid Personality Disorder (PPD) as per DSM-5.  The patient exhibits a pattern of distrust and suspicion, believing without sufficient basis that others are exploiting, harming, or deceiving them.  They are preoccupied with unjustified doubts about the loyalty or trustworthiness of friends and associates.  They are reluctant to confide in others due to unwarranted fear that the information will be used maliciously against them.  They persistently bear grudges, are unforgiving of insults, injuries, or slights, and perceive attacks on their character or reputation that are not apparent to others, reacting with anger or counterattacking.  They have recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.  Differential diagnoses considered include schizophrenia, delusional disorder, and other personality disorders.  The patient's symptoms are not attributable to the physiological effects of a substance or another medical condition.  Treatment plan includes individual psychotherapy focusing on cognitive behavioral therapy (CBT) techniques to address maladaptive thought patterns and improve interpersonal relationships.  Referral to a psychiatrist for medication management may be considered if indicated.  Prognosis is guarded but improvement in social functioning and interpersonal relationships is possible with consistent therapeutic intervention.  Current Procedural Terminology (CPT) codes for evaluation and management (E/M) services will be used for billing, with specific codes selected based on time spent and complexity of medical decision making.  ICD-10 code F60.0 will be used for Paranoid Personality Disorder.  Continued monitoring and reassessment are necessary to adjust treatment plan as needed.