F41.0 ICD-10-CM Code: Panic disorder [episodic paroxysmal anxiety]
F41.0 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Mental, Behavioral and Neurodevelopmental disorders (F01-F99) / Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48)
F41.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePanic disorder [episodic paroxysmal anxiety]
Panic disorder is a mental health condition characterized by sudden, repeated episodes of intense fear or panic attacks, often accompanied by physical symptoms like rapid heartbeat and sweating.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 133
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Panic attack
- Panic state
Excludes 2
Official- anxiety in:
- acute stress reaction (F43.0)
- transient adjustment reaction (F43.2)
- neurasthenia (F48.8)
- psychophysiologic disorders (F45.-)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for F41.0 in this effective period.
Excludes 1
Official- panic disorder with agoraphobia (F40.01)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for F41.0 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for F41.0 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for F41.0 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is F41.0 an HCC code?
F41.0 is not in the CMS-HCC V28 or V24 community payment model. F41.0 has a separate mapping under the Part D RxHCC model (HCC 133 (Anxiety and Other Psychiatric Disorders)); the applicable result needs member context.
- Code
- F41.0
- Description
- Panic disorder [episodic paroxysmal anxiety]
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work F41.0 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT Criteria for F41.0
For F41.0 to 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 F41.0 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
F41.0 is the ICD-10-CM diagnosis code for panic disorder [episodic paroxysmal anxiety]. Panic disorder is a mental health condition characterized by sudden, repeated episodes of intense fear or panic attacks, often accompanied by physical symptoms like rapid heartbeat and sweating. F41.0 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).
F41.0 has no mapping under the CMS-HCC V28 or V24 community payment models. F41.0 has a separate mapping under the Part D RxHCC model (HCC 133 (Anxiety and Other Psychiatric Disorders)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
Document the frequency and severity of panic episodes to support medical necessity.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for F41.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the frequency and severity of panic episodes to support medical necessity
- •Distinguish from other anxiety disorders by confirming the presence of discrete panic attacks rather than generalized worry
Documentation Requirements
- ✓Recurrent unexpected panic attacks documented with symptoms (palpitations, sweating, trembling, shortness of breath, chest pain, nausea, dizziness, etc.)
- ✓Persistent concern about additional attacks, worry about attack consequences, or behavioral changes related to attacks
- ✓Duration of at least 1 month of concern or behavioral change following attacks
- ✓Frequency and severity of panic attacks
- ✓Attacks are not attributable to substances or another medical condition
- ✓Current treatment plan including cognitive-behavioral therapy and/or pharmacotherapy (SSRIs, benzodiazepines)
Excludes 1, Do NOT code together
- panic disorder with agoraphobia (F40.01)
Commonly Confused Codes
- •F40.01 (Agoraphobia with panic disorder): Use F40.01 when both agoraphobia and panic disorder are documented; do not code F41.0 separately with F40.01
- •F41.1 (Generalized anxiety disorder): GAD involves chronic worry across multiple domains; panic disorder involves discrete panic attacks
- •R00.2 (Palpitations): Palpitations as a symptom of panic disorder should not be coded separately; code the underlying panic disorder
- •I49.9 (Cardiac arrhythmia, unspecified): Ensure cardiac evaluation has been performed before attributing symptoms to panic disorder