2025 ICD-10-CM code F40.0
Agoraphobia
The medical necessity for treating agoraphobia is established by documenting the significant impairment it causes in the patient's social, occupational, or other important areas of functioning. The diagnosis should be supported by the documented symptoms and their impact on the patient's quality of life.
- 6 (Mental, Behavioral and Neurodevelopmental disorders)
- Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48)
In simple words: Agoraphobia is a fear of being in situations where escape might be difficult or help might not be available if you were to experience a panic attack or other embarrassing or incapacitating symptoms. Common examples include using public transport, being in open or enclosed spaces, standing in line, or being in a crowd.
Agoraphobia is an anxiety disorder characterized by a fear of places and situations that might cause panic, helplessness, or embarrassment. Individuals with agoraphobia often experience intense anxiety or panic attacks in situations where they feel trapped, such as public transportation, open spaces, enclosed spaces, crowds, or being outside of their home alone. The fear is often disproportionate to the actual danger posed by the situation.
Example 1: A 25-year-old patient experiences overwhelming anxiety when riding the subway, fearing they will have a panic attack and be unable to escape. They now avoid using public transport altogether, significantly impacting their ability to work and socialize., A 40-year-old patient fears attending their child's school play in the crowded auditorium. They worry about having a panic attack and embarrassing themselves. They ultimately decide not to go, leading to feelings of disappointment and isolation., A 60-year-old patient with a history of heart problems develops agoraphobia after experiencing a medical emergency in a grocery store. They now fear leaving their home, worried they will have another health issue and be unable to get help.
Documentation should include a detailed description of the patient's fear and avoidance behaviors, including the specific situations they fear, the nature of their anxiety symptoms, and the impact of the phobia on their daily life. It is crucial to document the presence of fear or anxiety in at least two of the five characteristic situations: using public transport, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, and being outside of the home alone. Diagnostic criteria based on DSM-5 should be followed.
- Specialties:Psychiatry, Psychology, Primary Care
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home, Community Mental Health Center