F60.81

HCC Category Mapping

What This Code Means

A personality pattern involving excessive need for admiration, lack of empathy, and sense of entitlement or superiority.

Coding Tips

• •Document grandiose fantasies, preoccupation with success or power, and interpersonal exploitation
• •Differentiate from healthy self-esteem; narcissistic personality disorder involves pervasive patterns causing functional impairment

Clinical Significance

Narcissistic personality disorder is a Cluster B personality disorder characterized by a pervasive pattern of grandiosity, need for admiration, and lack of empathy. It significantly impacts treatment compliance, provider-patient relationships, and healthcare utilization patterns, as these patients often present with somatic complaints and comorbid depression or substance abuse. Accurate coding captures the complexity of care for these patients.

Documentation Requirements

• ✓Documented pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy present since early adulthood
• ✓Evidence of at least five DSM-5 criteria met (grandiose sense of self-importance, preoccupation with fantasies of success, belief of being special, excessive need for admiration, sense of entitlement, interpersonal exploitation, lack of empathy, envy, arrogant behaviors)
• ✓Functional impairment in interpersonal, occupational, or social domains
• ✓Provider assessment distinguishing narcissistic PD from narcissistic traits or normal personality variation
• ✓Treatment plan documentation including psychotherapy approach

Commonly Confused Codes