People indulge in self harm mainly to relieve emotional distress, cope with emotional pain, intense anger and frustration. Raising awareness about self-injury is incredibly important. March is observed as Self-Harm Awareness Month. During this month, several awareness organizations will make special efforts to raise awareness about self-harm and self-injury.
Though some individuals may attempt suicide, the self-injuring behavior is not the same as a suicide attempt. It has been reported that the majority of those who harm themselves are teenagers or young adults. Common symptoms for this disorder are – wearing concealed clothing even in warm weather, carrying sharp objects in their personal belongings without an apparent reason, and preferring to be alone for long periods of time.
Appropriate treatment can help patients with this disorder to learn healthier ways to cope. Diagnosis of this condition is based on physical and mental evaluation. A diagnosis may require evaluation by a mental health provider with experience in treating self-injury. This must be accurately documented to ensure the right treatment for the patient and the right reimbursement for the provider. Psychiatry medical billing requires the use of accurate and relevant medical codes to document the exact diagnosis results.
Some ICD-10 codes that are applicable to document purposely self-inflicted injury include:
- X71 – Intentional self-harm by drowning and submersion
- X75 – Intentional self-harm by explosive material
- X76 – Intentional self-harm by smoke, fire and flames
- X78 – Intentional self-harm by sharp object
- X80 – Intentional self-harm by jumping from a high place
- X81 – Intentional self-harm by jumping or lying in front of a moving object
A mental health provider may also evaluate the patient for other mental illnesses that may be linked to self-injury, such as depression or personality disorders. If that’s the case, evaluation may include additional tools, such as questionnaires or psychological tests.
Depression and self-harm often go hand-in-hand, though there are many other reasons why people engage in self-harm. Unlike general treatments, psychological treatments specific to self-harm have better success. If the self-injury behavior is associated with a mental health disorder, such as depression or borderline personality disorder, the treatment plan focuses on that disorder, as well as the self-injury behavior. Treating the depression and other mental health issues is critical in stopping self-harm behavior. Often medications are not used to specifically treat self-injuring behavior.
Several therapy or counseling techniques will be used to treat the disorder, which include:
- Cognitive behavioral therapy (CBT): This psychological treatment for self-injury focuses on identifying dysfunctional emotions, behaviors and causes of self-harm and then analyzes and replaces them with more positive ways of dealing with life.
- Dialectical behavior therapy: This therapy is typically used in teaching behavioral skills to help patients tolerate distress, manage or regulate their emotions, and improve their relationships with others.
- Psychotherapy: This therapy can help people prone to self-harm to develop other coping mechanisms that address their emotional pain. Specialists treating self-harm will also work with the patients to discuss their feelings of inadequacy, low self-worth, and self-hatred.
Considering the effective documentation of these therapies, medical billing and coding companies use the latest medical codes to document the therapy. Recently revised CPT codes for psychotherapy include:
- 90832 – Psychotherapy, 30 minutes with patient
- 90846 – Family psychotherapy (without the patient present), 50 minutes
- 90847 – Family psychotherapy (conjoint therapy) (with the patient present), 50 minutes
The latest update is that although another person (“informant”) may be in the room, individual psychotherapy codes are for individual treatment and the patient must be in the room “for all or a majority of the service”. Therapy focused on the family should be reported with family therapy codes.