Suspiciousness and marked evasiveness
ICD-10 R46.5 is a billable code used to indicate a diagnosis of suspiciousness and marked evasiveness.
R46.5 refers to a clinical presentation characterized by an individual's pervasive distrust and suspicion of others, often leading to marked evasiveness in social interactions. This symptom can manifest in various contexts, including psychiatric disorders, neurological conditions, or as a response to stress or trauma. Patients may exhibit behaviors such as avoiding eye contact, being defensive, or interpreting benign actions as threatening. The underlying causes can range from personality disorders, such as paranoid personality disorder, to acute stress reactions or substance-induced states. Clinicians should assess the duration, context, and associated symptoms to determine the underlying etiology. Proper documentation should include the patient's history, mental status examination, and any relevant psychosocial factors that may contribute to these behaviors. Understanding the clinical context is crucial for accurate diagnosis and treatment planning.
Documentation should include a detailed history of present illness, psychosocial factors, and any relevant medical history that may contribute to the patient's behavior.
Patients presenting with unexplained anxiety, chronic illness, or psychosomatic complaints may exhibit suspiciousness.
Consider the impact of chronic medical conditions on mental health and document any relevant comorbidities.
Acute care documentation should capture the patient's immediate behavior, any threats to safety, and the context of the emergency visit.
Patients in crisis situations, such as those experiencing acute psychosis or severe anxiety, may present with marked evasiveness.
Emergency settings require rapid assessment and documentation of the patient's mental state and any immediate interventions.
Used when evaluating a patient presenting with suspiciousness and evasiveness.
Comprehensive documentation of the patient's mental status, history, and presenting symptoms.
Ensure that the evaluation captures the context of the patient's behavior.
R46.5 should be used when a patient presents with suspiciousness and marked evasiveness as a primary concern, and when no more specific diagnosis is applicable.
