What is ICD-10 code F40.11?

F40.11 is the ICD-10-CM diagnosis code for Social phobia, generalized. A persistent fear of social situations where the person might be judged, embarrassed, or scrutinized by others, affecting multiple social contexts. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F40.11 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F40.11 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. F40.11 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. F40.11 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for F40.11?

F40.11 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards F40.11 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

What should coders know when reporting F40.11?

Distinguish between generalized social phobia (F40.11) and specific social phobia (F40.10) Document which social situations trigger anxiety (public speaking, eating in public, meeting new people)

F40.11 ICD-10 Code: Social phobia, generalized

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupF40.11Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48)

F40.11

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Social phobia, generalized

A persistent fear of social situations where the person might be judged, embarrassed, or scrutinized by others, affecting multiple social contexts.

Buddy Insight

Social phobia, generalized, indicates social anxiety that extends across most social situations rather than being limited to specific performance situations.

CMS-HCC V28

Not risk-adjusted for this model/period.

RAF 0

CMS-HCC V24

Not risk-adjusted for this model/period.

RAF 0

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 133

Personality Disorders, Anxiet...

RAF 0.0

Code Trumping

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Code Book Path

Official

F40Phobic anxiety disorders

F40.1Social phobias

F40.11Social phobia, generalized

Inclusion Terms

Official

Anthropophobia
Social anxiety disorder
Social anxiety disorder of childhood
Social neurosis

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F40.11 in this effective period.

Related Child Codes

Official

F40.10Social phobia, unspecified

Includes

Official

ICD-10-CM does not list Includes notes for F40.11 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F40.11 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F40.11 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F40.11 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F40.11 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Fear or anxiety documented across most social situations (not limited to performance anxiety)

Social situations consistently provoke fear or anxiety

Avoidance or endurance with intense distress

Duration of 6+ months

MEAT Support

HCC Buddy guidance

Fear or anxiety documented across most social situations (not limited to performance anxiety)

Social situations consistently provoke fear or anxiety

Avoidance or endurance with intense distress

Duration of 6+ months

Audit Caution

HCC Buddy guidance

Defaulting to F40.10 when documentation actually supports the generalized specifier

Coding F40.11 when the patient only has performance anxiety (e.g., public speaking) — this is not generalized social phobia

Using both F40.11 and F60.6 without documentation supporting both diagnoses as distinct clinical entities

Assigning this code based on patient self-report alone without clinical evaluation documented

Common Mistakes

HCC Buddy guidance

F40.10 (Social phobia, unspecified) — Use F40.11 when documentation specifies the anxiety is generalized across most social contexts

F60.6 (Avoidant personality disorder) — Avoidant personality disorder is a pervasive personality pattern; social phobia is an anxiety disorder, though they can coexist

F41.1 (Generalized anxiety disorder) — GAD involves worry about many topics; generalized social phobia is specifically about social evaluation across situations

F40.8 (Other phobic anxiety disorders) — Use the specific social phobia code when social anxiety is the documented condition

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is F40.11 an HCC code?

No. F40.11 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

HCC Category Mapping

RxHCCHCC 133, Personality Disorders, Anxiety, and Other Specified Mental Disorders

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for F40.11

For F40.11to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed F40.11 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

F40.11 is the ICD-10-CM diagnosis code for social phobia, generalized. A persistent fear of social situations where the person might be judged, embarrassed, or scrutinized by others, affecting multiple social contexts. F40.11 sits in the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99), within the section covering anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (f40-f48).

F40.11 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

F40.11 does not map to any HCC under V24 or V28 and has no RAF weight. No ESRD HCC mapping. RxHCC maps to RxHCC 133 at 0.0 weight. This is a non-risk-adjusting diagnosis. Coders reviewing F40.11 should check whether additional documentation would support a more specific child code in the same hierarchy that does map to a payment HCC, capturing the correct specificity is the highest-impact RAF improvement available within accurate coding.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for F40.11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Distinguish between generalized social phobia (F40.11) and specific social phobia (F40.10)
•Document which social situations trigger anxiety (public speaking, eating in public, meeting new people)

Clinical Significance

Social phobia, generalized, indicates social anxiety that extends across most social situations rather than being limited to specific performance situations. This specification is clinically important as generalized social phobia typically requires more intensive treatment and has a greater impact on functioning. It does not map to any HCC and is not risk-adjusting.

Documentation Requirements

✓Fear or anxiety documented across most social situations (not limited to performance anxiety)
✓Social situations consistently provoke fear or anxiety
✓Avoidance or endurance with intense distress
✓Duration of 6+ months
✓Significant impairment in social, occupational, or other areas of functioning
✓Current treatment plan including cognitive-behavioral therapy and/or pharmacotherapy

Commonly Confused Codes

•F40.10 (Social phobia, unspecified) — Use F40.11 when documentation specifies the anxiety is generalized across most social contexts
•F60.6 (Avoidant personality disorder) — Avoidant personality disorder is a pervasive personality pattern; social phobia is an anxiety disorder, though they can coexist
•F41.1 (Generalized anxiety disorder) — GAD involves worry about many topics; generalized social phobia is specifically about social evaluation across situations
•F40.8 (Other phobic anxiety disorders) — Use the specific social phobia code when social anxiety is the documented condition

Child Codes

F40.10Social phobia, unspecified

F40.11Social phobia, generalized

Code Hierarchy

└F40Phobic anxiety disorders └F40.1Social phobias └F40.11Social phobia, generalized

└F40.11Social phobia, generalized

F40.11 ICD-10-CM Code: Social phobia, generalized

HCC Buddy Code Card

F40.11

Is F40.11 an HCC code?

HCC Category Mapping

MEAT Criteria for F40.11

What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Commonly Confused Codes

Child Codes

Code Hierarchy

Open F40.11 in the Interactive Encoder