Self Injurious Behavior ICD-10-CM Codes | 2025

What ICD-10 codes are used for self-injurious behavior?

Self-injurious behavior refers to the deliberate act of harming one’s own body often as a way to cope with emotional pain, stress, or difficult feelings. Common forms include cutting, burning, or hitting oneself, and it can be a sign of underlying mental health issues.

When it comes to self-injurious behavior, healthcare professionals use specific codes to document and classify such instances. Below are the commonly used self-injurious behavior ICD-10 codes: 

R45.88: Nonsuicidal self-harm

X72: Intentional self-harm by handgun discharge

• X72.XXXA: Intentional self-harm by handgun discharge, initial encounter
• X72.XXXD: Intentional self-harm by handgun discharge, subsequent encounter
• X72.XXXS: Intentional self-harm by handgun discharge, sequela

T14.91: Suicide attempt

• T14.91XA: Suicide attempt, initial encounter
• T14.91XD: Suicide attempt, subsequent encounter
• T14.91XS: Suicide attempt, sequela

X78.0: Intentional self-harm by sharp glass

• X78.0XXA: Intentional self-harm by sharp glass, initial encounter
• X78.0XXD: Intentional self-harm by sharp glass, subsequent encounter
• X78.0XXS: Intentional self-harm by sharp glass, sequela

X78.1: Intentional self-harm by knife

• X78.1XXA: Intentional self-harm by knife, initial encounter
• X78.1XXD: Intentional self-harm by knife, subsequent encounter
• X78.1XXS: Intentional self-harm by knife, sequela

X78.9: Intentional self-harm by unspecified sharp object

• X78.9XXA: Intentional self-harm by other sharp object, initial encounter
• X78.9XXD: Intentional self-harm by unspecified sharp object, subsequent encounter
• X78.9XXS: Intentional self-harm by unspecified sharp object, sequela

It's crucial for healthcare professionals to accurately assign these self-injurious and suicidal intent codes to ensure proper documentation and appropriate care for individuals. A comprehensive assessment of the patient's mental health should accompany these codes to guide effective treatment strategies.

Which self-injurious behavior ICD codes are billable?

The ICD-10 codes listed above are billable only when fully detailed, including the 7th character for encounter type (A, D, or S). For reimbursement, incomplete codes like X78.1 and T14.91 are not accepted.

Clinical information

• Self-injurious behavior, a complex phenomenon, encompasses deliberate acts causing harm like cutting or burning and is rooted in multifaceted psychological factors. 
• Frequently associated with mental health disorders such as depression, anxiety, or borderline personality disorder, it serves as a maladaptive coping mechanism for individuals grappling with overwhelming emotional distress or trauma.
• Self-injurious behavior can show up in different ways, like hand biting when anxious or wearing long pants and long sleeves to hide fresh cuts. For example, a teen might cover their arms even in hot weather to avoid questions about their injuries.
• Diverse risk factors contribute, with an elevated prevalence among those with a history of trauma or substance abuse. 
• To diagnose self-injurious behavior, healthcare providers look for signs like cutting or head banging, often linked to mental health issues or physical pain. A thorough evaluation is needed to understand the reasons behind the behavior and any co-occurring conditions, like a tendency to self-injure.
• Treatment approaches, often multidisciplinary, integrate psychiatric, psychological, and social work perspectives, with psychotherapeutic modalities like dialectical behavior therapy (DBT) proving effective.
• Crisis intervention plans are developed to address acute episodes promptly, and accessible emergency mental health services are ensured.
• Collaboration with caregivers is integral, involving them in treatment planning and educating them on recognizing warning signs. 

Synonyms include

• Self-harm
• Deliberate self-injury
• Auto-aggression
• Self-mutilation
• Self-inflicted harm
• Non-suicidal self-harm
• Autolesion
• Self-destructive behavior
• Self-wounding
• Deliberate self-damage