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ICD-10 Coding for Panic Disorder with Agoraphobia(F40.01, F41.0)

Complete ICD-10-CM coding and documentation guide for Panic Disorder with Agoraphobia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Panic Disorder with Agoraphobic AvoidanceAgoraphobia with Panic Attacks

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Related ICD-10 Code Ranges

Complete code families applicable to Panic Disorder with Agoraphobia

F40-F48Primary Range

Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders

This range includes all anxiety disorders, including panic disorder with agoraphobia.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
F40.01Agoraphobia with panic disorderUse when both panic attacks and agoraphobic avoidance are present.
  • Recurrent unexpected panic attacks
  • Avoidance of ≥2 agoraphobic situations
  • Symptoms not attributable to substance use or medical condition
F41.0Panic disorder [episodic paroxysmal anxiety] without agoraphobiaUse when panic attacks occur without any agoraphobic avoidance.
  • Recurrent unexpected panic attacks
  • No agoraphobic avoidance

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for panic disorder with agoraphobia

Essential facts and insights about Panic Disorder with Agoraphobia

The ICD-10 code for panic disorder with agoraphobia is F40.01, used when both panic attacks and agoraphobic avoidance are present.

Primary ICD-10-CM Codes for panic disorder with agoraphobia

F40.01
Agoraphobia with panic disorder
Billable Code

Decision Criteria

clinical Criteria

  • Presence of both panic attacks and avoidance of ≥2 situations

documentation Criteria

  • Detailed documentation of panic attack frequency and agoraphobic situations

Applicable To

  • Panic disorder with agoraphobia

Excludes

  • Panic disorder without agoraphobia (F41.0)

Clinical Validation Requirements

  • Recurrent unexpected panic attacks
  • Avoidance of ≥2 agoraphobic situations
  • Symptoms not attributable to substance use or medical condition

Code-Specific Risks

  • Incorrectly coding as F41.0 when agoraphobia is present

Coding Notes

  • Ensure documentation supports both panic attacks and agoraphobic avoidance.
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Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Problems related to social environment

Z60.0
Use when social exclusion or avoidance is documented.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Panic disorder without agoraphobia

F41.0
Use when panic attacks occur without agoraphobic avoidance.

Agoraphobia with panic disorder

F40.01
Use when both panic attacks and agoraphobic avoidance are present.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Panic Disorder with Agoraphobia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F40.01.

Impact

Clinical: Inadequate treatment planning, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials

Mitigation Strategy

Use specific language to describe symptoms, Document frequency and context of symptoms

Impact

Reimbursement: Potential claim denials due to incorrect coding, Compliance: Non-compliance with ICD-10 guidelines, Data Quality: Inaccurate patient records and data

Mitigation Strategy

Verify and document agoraphobic avoidance to use F40.01.

Impact

Using F41.0 instead of F40.01 when agoraphobia is present

Mitigation Strategy

Ensure thorough documentation of agoraphobic avoidance

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Panic Disorder with Agoraphobia, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Panic Disorder with Agoraphobia

Use these documentation templates to ensure complete and accurate documentation for Panic Disorder with Agoraphobia. These templates include all required elements for proper coding and billing.

Patient with panic attacks and agoraphobic avoidance

Specialty: Psychiatry

Required Elements

  • History of panic attacks
  • Agoraphobic situations
  • DSM-5 criteria alignment

Example Documentation

Patient reports 4 panic attacks in the past month, avoids supermarkets and public transport due to fear of being unable to escape.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has anxiety attacks.
Good Documentation Example
Patient reports 4 panic attacks in past month characterized by palpitations, trembling, and fear of dying. Avoids supermarkets and public transportation for 6 weeks due to fear of being unable to escape.
Explanation
The good example provides specific details on panic attack frequency, symptoms, and agoraphobic avoidance.

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