What is ICD-10 code F40.248?

F40.248 is the ICD-10-CM diagnosis code for Other situational type phobia. An intense, irrational fear related to specific situations not otherwise specified, such as fear of tunnels, storms, or other environmental triggers. It belongs to the ICD-10-CM chapter for mental, behavioral and neurodevelopmental disorders (f01-f99). F40.248 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. F40.248 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. F40.248 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. F40.248 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 F40.248?

F40.248 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 community model rewards F40.248 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's V28/V24 community RAF score in either version. It does, however, map under the Part D RxHCC model (Personality Disorders, Anxiety, and Other Specified Mental Disorders), which affects the ESRD and/or Part D (RxHCC) risk scores. Coders should check whether provider documentation supports a more specific child code that does map to a community payment HCC.

What should coders know when reporting F40.248?

Use this code only when the specific situational phobia is not captured by F40.240-F40.243 Document the specific situation that triggers the fear in the medical record

2026 ICD-10-CM F40.248: Other situational type phobia

ICD-10-CM Code View

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Code lookupF40.248Effective 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)

F40.248

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

Other situational type phobia

An intense, irrational fear related to specific situations not otherwise specified, such as fear of tunnels, storms, or other environmental triggers.

Buddy Insight

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

Mapped

HCC 133

Personality Disorders, Anxiet...

RAF 0.035

Code Book Path

Official

F40.2Specific (isolated) phobias

F40.24Situational type phobia

F40.248Other situational type phobia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for F40.248 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for F40.248 in this effective period.

Related Child Codes

Official

F40.240Claustrophobia

F40.241Acrophobia

F40.242Fear of bridges

F40.243Fear of flying

Includes

Official

ICD-10-CM does not list Includes notes for F40.248 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for F40.248 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for F40.248 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for F40.248 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for F40.248 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Specific situational stimulus documented (driving, tunnels, public transit, etc.)

Marked fear or anxiety about the specific situation

Fear is disproportionate to actual danger

Consistent avoidance or endurance with intense distress

MEAT Support

HCC Buddy guidance

Specific situational stimulus documented (driving, tunnels, public transit, etc.)

Marked fear or anxiety about the specific situation

Fear is disproportionate to actual danger

Consistent avoidance or endurance with intense distress

Audit Caution

HCC Buddy guidance

Using F40.248 when a more specific situational phobia code exists — always check for specific codes first

Coding multiple specific situational phobias under F40.248 when individual codes are available

Not specifying the particular situation in documentation when using this residual code

Confusing situational phobias with agoraphobia when multiple situations are feared

Common Mistakes

HCC Buddy guidance

F40.240 (Claustrophobia) — Use the specific code for enclosed space phobia rather than F40.248

F40.241 (Acrophobia) — Use the specific code for height phobia rather than F40.248

F40.242 (Fear of bridges) — Use the specific code for bridge phobia rather than F40.248

F40.243 (Fear of flying) — Use the specific code for flying phobia rather than F40.248

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 F40.248 an HCC code?

F40.248 is not in the CMS-HCC V28 or V24 community payment model, but it does map to Personality Disorders, Anxiety, and Other Specified Mental Disorders under the Part D RxHCC model.

Code: F40.248
Description: Other situational type phobia
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

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

0.035

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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.

Work F40.248 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for F40.248

For F40.248to 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 F40.248 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

F40.248 is the ICD-10-CM diagnosis code for other situational type phobia. An intense, irrational fear related to specific situations not otherwise specified, such as fear of tunnels, storms, or other environmental triggers. F40.248 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).

F40.248 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.

This code does not map to a CMS-HCC V28 payment category. Capture depends on documentation that supports the diagnosis; verify the HCC assignment against the current CMS mapping for the applicable payment year. Coders reviewing F40.248 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 F40.248 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Use this code only when the specific situational phobia is not captured by F40.240-F40.243
•Document the specific situation that triggers the fear in the medical record

Clinical Significance

Other situational type phobia is a residual category for situational phobias that do not have their own specific ICD-10-CM code, such as fear of driving, fear of tunnels, or fear of public transportation. This code captures clinically significant situational fears not elsewhere classified. It does not carry risk adjustment value.

Documentation Requirements

✓Specific situational stimulus documented (driving, tunnels, public transit, etc.)
✓Marked fear or anxiety about the specific situation
✓Fear is disproportionate to actual danger
✓Consistent avoidance or endurance with intense distress
✓Duration of 6+ months
✓Functional impairment documented

Commonly Confused Codes

•F40.240 (Claustrophobia): Use the specific code for enclosed space phobia rather than F40.248
•F40.241 (Acrophobia): Use the specific code for height phobia rather than F40.248
•F40.242 (Fear of bridges): Use the specific code for bridge phobia rather than F40.248
•F40.243 (Fear of flying): Use the specific code for flying phobia rather than F40.248
•F40.00 (Agoraphobia, unspecified): Agoraphobia requires fear across multiple situation types; a single situational phobia is coded here