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F40.240

Billable

Claustrophobia

HCC Category Mapping

RxHCCHCC 133Personality Disorders, Anxiety, and Other Specified Mental Disorders
0.000

What This Code Means

An intense, irrational fear of enclosed or confined spaces such as elevators, small rooms, or crowded areas.

Coding Tips

  • Document the specific enclosed spaces that trigger the fear to support medical necessity
  • Distinguish from agoraphobia (F40.0) which involves fear of open or public spaces

Clinical Significance

Claustrophobia is a situational type specific phobia involving intense fear of enclosed or confined spaces such as elevators, tunnels, MRI machines, or small rooms. This phobia has direct healthcare implications as it can prevent patients from undergoing necessary diagnostic procedures like MRI scans or CT scans. It does not carry risk adjustment value.

Documentation Requirements

  • Marked fear or anxiety about enclosed or confined spaces
  • Specific triggering situations documented (elevators, tunnels, MRI machines, airplanes, etc.)
  • Consistent anxiety response upon exposure or anticipation
  • Avoidance behaviors and their impact on daily functioning and healthcare access
  • Duration of 6+ months
  • Management strategies (e.g., open MRI alternatives, anxiolytic pre-medication, behavioral therapy)

Commonly Confused Codes

Code Hierarchy

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