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ICD-10 Guide
ICD-10 CodesF06.4

F06.4

Billable

Anxiety disorder due to known physiological condition

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 F06.4 is a billable code used to indicate a diagnosis of anxiety disorder due to known physiological condition.

Key Diagnostic Point:

Anxiety disorder due to known physiological condition is classified under organic mental disorders, which are mental health conditions that arise from identifiable physiological causes. This code is used when anxiety symptoms are directly linked to a medical condition, such as a chronic illness, hormonal imbalance, or neurological disorder. The anxiety experienced is not a primary psychiatric disorder but rather a secondary response to the underlying physiological issue. Clinicians must document the specific physiological condition contributing to the anxiety, as this is crucial for accurate coding and treatment planning. Symptoms may include excessive worry, restlessness, and physical manifestations such as increased heart rate or sweating. The diagnosis requires a thorough assessment to differentiate it from primary anxiety disorders and to ensure that the physiological condition is adequately addressed in the treatment plan.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires clear documentation linking anxiety to a specific physiological condition.
  • Differentiation from primary anxiety disorders can be challenging.
  • Potential overlap with other mental health diagnoses necessitates careful review.
  • Need for comprehensive patient history to establish causality.

Audit Risk Factors

  • Insufficient documentation linking anxiety to the physiological condition.
  • Failure to specify the underlying medical condition.
  • Inconsistent use of terminology between providers.
  • Lack of follow-up documentation to support ongoing treatment.

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Detailed psychiatric evaluation linking anxiety symptoms to physiological conditions.

Common Clinical Scenarios

Patients with anxiety stemming from chronic illnesses like diabetes or thyroid disorders.

Billing Considerations

Psychiatrists must collaborate with other specialists to ensure comprehensive care and accurate coding.

Internal Medicine

Documentation Requirements

Thorough documentation of the physiological condition and its impact on mental health.

Common Clinical Scenarios

Patients presenting with anxiety symptoms related to cardiovascular diseases or metabolic disorders.

Billing Considerations

Internal medicine providers should be aware of the psychological implications of chronic conditions.

Coding Guidelines

Inclusion Criteria

Use F06.4 When
  • According to ICD
  • 10 coding guidelines, F06
  • 4 should be used when anxiety is a direct result of a known physiological condition
  • Coders must ensure that the physiological condition is documented and that the anxiety symptoms are not better explained by a primary anxiety disorder
  • The code should not be used if the anxiety is independent of the physiological condition

Exclusion Criteria

Do NOT use F06.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits where anxiety due to a physiological condition is managed.

Documentation Requirements

Document the patient's anxiety symptoms and the physiological condition being treated.

Specialty Considerations

Psychiatrists and internists should ensure comprehensive notes reflecting the interplay between physical and mental health.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more precise coding of anxiety disorders linked to physiological conditions, improving the ability to track and manage these cases. It emphasizes the need for comprehensive documentation and clinical correlation, which can enhance patient care and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more precise coding of anxiety disorders linked to physiological conditions, improving the ability to track and manage these cases. It emphasizes the need for comprehensive documentation and clinical correlation, which can enhance patient care and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more precise coding of anxiety disorders linked to physiological conditions, improving the ability to track and manage these cases. It emphasizes the need for comprehensive documentation and clinical correlation, which can enhance patient care and treatment outcomes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What documentation is required to support the use of F06.4?

Documentation must clearly link the anxiety symptoms to a specific physiological condition, including details of the medical diagnosis, treatment plan, and any relevant clinical assessments.