F41.0

Billable

Panic disorder [episodic paroxysmal anxiety]

HCC Category Mapping

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

0.000

What This Code Means

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.

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

Clinical Significance

Panic disorder (episodic paroxysmal anxiety) is characterized by recurrent unexpected panic attacks with persistent worry about additional attacks or their consequences. It is one of the most common anxiety disorders, affecting approximately 2-3% of the population, and is associated with significant healthcare utilization including emergency department visits. It does not map to any HCC under V24 or V28 but is important for clinical management.

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

Code Hierarchy

└F41Other anxiety disorders └F41.0Panic disorder [episodic paroxysmal anxiety]

└F41.0Panic disorder [episodic paroxysmal anxiety]