F40.01
BillableAgoraphobia with panic disorder
HCC Category Mapping
RxHCCHCC 133 — Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.000What This Code Means
An anxiety disorder combining agoraphobia (fear of open or crowded spaces) with panic disorder (sudden episodes of intense fear and physical symptoms).
Coding Tips
- •This code indicates both conditions are present; do not code agoraphobia and panic disorder separately when they occur together
- •Document the frequency and severity of panic attacks occurring with the agoraphobia
Clinical Significance
Agoraphobia with panic disorder represents the dual diagnosis of agoraphobic avoidance with co-occurring panic attacks in feared situations. This combination often results in more severe functional impairment than either condition alone, requiring more intensive treatment. It does not carry HCC risk adjustment value under V24 or V28 but is important for clinical management and care planning.
Documentation Requirements
- ✓Marked fear or avoidance of two or more agoraphobic situations
- ✓Documented panic attacks occurring in context of agoraphobic situations
- ✓Panic attack symptoms described (palpitations, sweating, trembling, shortness of breath, chest pain, etc.)
- ✓Duration of symptoms (typically 6+ months for agoraphobia)
- ✓Functional impact on daily living and healthcare access
- ✓Current treatment plan addressing both agoraphobia and panic disorder
Excludes 1 — Do NOT code together
- panic disorder without agoraphobia (F41.0)
Commonly Confused Codes
F40.00 (Agoraphobia, unspecified) — Use F40.01 when panic disorder is explicitly documented alongside agoraphobiaF40.02 (Agoraphobia without panic disorder) — Use when documentation explicitly excludes panic disorderF41.0 (Panic disorder) — Use F41.0 alone when panic disorder exists without agoraphobic avoidanceF40.9 (Phobic anxiety disorder, unspecified) — Too nonspecific; use F40.01 when both agoraphobia and panic disorder are documented
Code Hierarchy
└F40Phobic anxiety disorders└F40.0Agoraphobia└F40.01Agoraphobia with panic disorder
└F40.01Agoraphobia with panic disorder