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ICD-10 Guide
ICD-10 CodesF40.02

F40.02

Billable

Agoraphobia without panic disorder

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

Code Description

ICD-10 F40.02 is a billable code used to indicate a diagnosis of agoraphobia without panic disorder.

Key Diagnostic Point:

Agoraphobia without panic disorder is characterized by an intense fear or anxiety about being in situations where escape might be difficult or help unavailable in the event of a panic attack or similar incapacitating symptoms. Individuals may avoid public places, crowds, or traveling alone, leading to significant impairment in daily functioning. Unlike agoraphobia with panic disorder, this condition does not involve recurrent panic attacks. The fear is often linked to the anticipation of anxiety-provoking situations rather than actual panic episodes. Diagnosis is based on clinical assessment, including patient history and symptom evaluation, and must meet the criteria outlined in the DSM-5. Treatment typically involves cognitive-behavioral therapy (CBT), exposure therapy, and sometimes pharmacotherapy, focusing on anxiety management techniques to help patients gradually face feared situations and reduce avoidance behaviors.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between agoraphobia with and without panic disorder
  • Understanding the nuances of anxiety disorders
  • Documentation of symptom severity and impact on daily life
  • Potential overlap with other anxiety disorders like PTSD and OCD

Audit Risk Factors

  • Inadequate documentation of symptoms and their impact
  • Misclassification of agoraphobia type
  • Failure to document treatment plans and patient progress
  • Inconsistent use of diagnostic criteria

Specialty Focus

Medical Specialties

Psychiatry

Documentation Requirements

Comprehensive patient history, symptom assessment, treatment plans, and progress notes.

Common Clinical Scenarios

Patients presenting with avoidance behaviors, difficulty in social situations, and requests for therapy or medication.

Billing Considerations

Ensure clear differentiation between agoraphobia types and document any comorbid anxiety disorders.

Psychology

Documentation Requirements

Detailed psychological evaluations, therapy session notes, and patient self-reports.

Common Clinical Scenarios

Patients undergoing cognitive-behavioral therapy for anxiety management and exposure therapy.

Billing Considerations

Focus on documenting therapeutic techniques used and patient responses to treatment.

Coding Guidelines

Inclusion Criteria

Use F40.02 When
  • Follow the ICD
  • CM coding guidelines for mental disorders, ensuring accurate documentation of the patient's symptoms, history, and treatment
  • Include specific details about the patient's avoidance behaviors and their impact on functioning

Exclusion Criteria

Do NOT use F40.02 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

90834CPT Code

Psychotherapy, 45 minutes with patient

Clinical Scenario

Used for therapy sessions focusing on anxiety management.

Documentation Requirements

Session notes detailing patient progress and therapeutic techniques used.

Specialty Considerations

Psychiatrists and psychologists should document the specific focus on agoraphobia symptoms.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mental health disorders, including agoraphobia, which aids in better tracking and treatment of these conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mental health disorders, including agoraphobia, which aids in better tracking and treatment of these conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of mental health disorders, including agoraphobia, which aids in better tracking and treatment of these conditions.

Resources

Clinical References

  • •
    American Psychiatric Association - DSM-5

Coding & Billing References

  • •
    American Psychiatric Association - DSM-5

Frequently Asked Questions

What is the difference between agoraphobia and panic disorder?

Agoraphobia is characterized by fear of situations where escape might be difficult, while panic disorder involves recurrent panic attacks. Agoraphobia can occur with or without panic disorder.