Homicidal ideations
ICD-10 R45.850 is a billable code used to indicate a diagnosis of homicidal ideations.
Homicidal ideations refer to thoughts or fantasies about killing another person. This symptom can arise in various psychiatric conditions, including major depressive disorder, schizophrenia, and personality disorders. Patients may express these thoughts verbally or through written communication, and they can range from fleeting thoughts to detailed plans. The presence of homicidal ideations often indicates a significant risk of violence and necessitates immediate clinical assessment and intervention. Clinicians must evaluate the context of these thoughts, including any associated factors such as substance abuse, recent trauma, or significant life stressors. The assessment should also consider the patient's history of violence, current mental state, and any protective factors that may mitigate risk. Accurate documentation of the ideations, their severity, and any associated behaviors is crucial for appropriate coding and treatment planning.
Documentation should include a detailed history of the ideations, associated symptoms, and any interventions taken.
Patients presenting with chronic illness may express frustration leading to homicidal thoughts, necessitating a mental health evaluation.
Internal medicine providers should be aware of the interplay between physical health and mental health, ensuring comprehensive assessments.
Acute care documentation must capture the patient's mental status, any immediate threats, and interventions initiated.
Patients presenting to the emergency department with acute distress may express homicidal ideations, requiring rapid assessment and intervention.
Emergency providers must prioritize safety and may need to involve psychiatric services for further evaluation.
Used when evaluating a patient with homicidal ideations.
Comprehensive history and mental status examination.
Ensure thorough documentation of risk factors and ideations.
Document the patient's thoughts, context, severity, any associated risk factors, and interventions taken. Ensure that the documentation supports the diagnosis and reflects the clinical decision-making process.
