Understand paranoid delusions, their diagnostic criteria, and clinical documentation for accurate medical coding. This resource covers symptoms, differential diagnosis, treatment options, and ICD-10 codes related to persecutory delusions, delusional disorder, and psychosis. Find information for healthcare professionals on best practices for documenting paranoia and delusional thinking in patient charts, ensuring proper reimbursement and quality care.
Also known as
Persistent delusional disorders
Encompasses various delusional disorders, including paranoid delusions.
Schizophrenia, schizotypal
Includes conditions where delusions, like paranoia, can be a prominent feature.
Other mental disorders due to brain damage
Paranoid delusions can arise from brain damage or dysfunction.
Paranoid ideation
Specifically designates paranoid ideation, closely related to paranoid delusions.
Follow this step-by-step guide to choose the correct ICD-10 code.
Are the delusions persecutory in nature?
Yes
Is it due to a medical condition?
No
Other type of paranoid delusion?
When to use each related code
| Description |
|---|
| Fixed false beliefs despite evidence. |
| Delusions and hallucinations in schizophrenia. |
| Brief psychosis with delusions or hallucinations. |
Coding F22 without specifying the delusional content (e.g., persecutory, grandiose) leads to inaccurate severity and impacts DRG assignment.
Coding suspected or ruled-out paranoia as confirmed diagnoses leads to inflated reimbursement and compliance violations.
Insufficient documentation of co-existing conditions (e.g., anxiety, depression) with F22 can lead to undercoding and missed CC/MCC capture.
Patient presents with persistent paranoid delusions, characterized by fixed, false beliefs that are persecutory in nature. The patient reports experiencing these delusions for approximately [duration], impacting their social functioning and causing significant distress. Symptoms include [specific delusion content e.g., belief of being spied on, poisoned, followed, conspired against]. These beliefs are not congruent with the patient's cultural or religious background and are maintained despite evidence to the contrary. Differential diagnosis includes schizophrenia, delusional disorder, substance-induced psychotic disorder, and mood disorders with psychotic features. Assessment includes a thorough mental status examination, review of medical history, and consideration of contributing factors such as substance use and medical conditions. The patient's insight into their delusional beliefs is [present/absent/limited]. Judgment and decision-making appear [impaired/intact]. Current treatment plan focuses on establishing a therapeutic alliance, initiating antipsychotic medication [medication name and dosage if applicable], and providing psychoeducation about paranoid delusions and their management. Risk assessment for self-harm and harm to others was conducted and determined to be [low/moderate/high]. Patient is scheduled for follow-up appointment in [timeframe] to monitor symptom response to treatment and adjust the plan as needed. ICD-10 code F22.0 (Paranoid schizophrenia) or F22.8 (Other persistent delusional disorders) may be considered depending on the complete clinical picture. CPT codes for evaluation and management services will be documented based on the complexity of the visit. Continued monitoring and reassessment are crucial for optimizing treatment outcomes and addressing the patient's overall mental health needs.