F40.02
BillableAgoraphobia without panic disorder
HCC Category Mapping
RxHCCHCC 133 — Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.000What This Code Means
An anxiety disorder where a person has intense fear of being in open or crowded spaces and avoids situations where escape might be difficult, but without experiencing panic attacks.
Coding Tips
- •Ensure panic disorder is not present; if panic attacks occur, use F40.01 instead
- •Document the specific situations avoided (crowds, public transportation, open spaces) for clinical clarity
Clinical Significance
Agoraphobia without panic disorder specifies that the patient experiences agoraphobic fear and avoidance without co-occurring panic attacks. This distinction is clinically meaningful because treatment approaches may differ when panic disorder is absent. It does not map to any HCC under V24 or V28 and is not a risk-adjusting diagnosis.
Documentation Requirements
- ✓Marked fear or avoidance of two or more agoraphobic situations
- ✓Explicit documentation that panic disorder is not present
- ✓Duration of symptoms (typically 6+ months)
- ✓Description of avoidance behaviors and their functional impact
- ✓Mental status examination findings
- ✓Current treatment approach (often cognitive-behavioral therapy focused)
Commonly Confused Codes
F40.01 (Agoraphobia with panic disorder) — Use when panic attacks are documented in agoraphobic situationsF40.00 (Agoraphobia, unspecified) — Use when documentation does not specify whether panic disorder is presentF40.10 (Social phobia, unspecified) — Social phobia involves fear of social scrutiny, not escape difficultyF41.1 (Generalized anxiety disorder) — GAD involves pervasive worry across multiple domains, not situation-specific avoidance
Code Hierarchy
└F40Phobic anxiety disorders└F40.0Agoraphobia└F40.02Agoraphobia without panic disorder
└F40.02Agoraphobia without panic disorder