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F60.0

Billable

Paranoid personality disorder

HCC Category Mapping

V28HCC 153Personality Disorders and Dissociative Disorders
1.241
V24HCC 60Personality Disorders
0.000
ESRDHCC 60Personality Disorders
0.000
RxHCCHCC 133Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.000

What This Code Means

A personality pattern characterized by persistent distrust and suspicion of others, interpreting their actions as deliberately harmful or threatening.

Coding Tips

  • Document specific examples of paranoid ideation or suspicious behavior patterns in the clinical record
  • Distinguish from paranoid delusions in psychotic disorders; paranoid personality disorder involves personality traits rather than fixed false beliefs

Clinical Significance

Paranoid personality disorder is characterized by a pervasive pattern of distrust and suspiciousness of others, interpreting their motives as malevolent. This enduring pattern significantly impacts healthcare engagement, medication compliance, and therapeutic relationships. Patients often refuse treatment or have adversarial relationships with providers, complicating management of comorbid conditions.

Documentation Requirements

  • Documentation of pervasive distrust and suspiciousness of others beginning by early adulthood
  • Evidence of at least four of the DSM-5 criteria (suspects exploitation/harm, doubts loyalty, reluctant to confide, reads demeaning meanings, bears grudges, perceives attacks on character, suspicious of partner fidelity)
  • Pattern is enduring, inflexible, and pervasive across contexts (not limited to specific situations)
  • Does not occur exclusively during schizophrenia, bipolar disorder, or depressive disorder with psychotic features
  • Functional impairment in occupational and interpersonal domains

Excludes 2 — Not included here, may code separately

  • paranoia (F22)
  • paranoia querulans (F22)
  • paranoid psychosis (F22)
  • paranoid schizophrenia (F20.0)
  • paranoid state (F22)

Commonly Confused Codes

Code Hierarchy

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