2025 ICD-10-CM code F40.2
(Active) Effective Date: N/A Revision Date: N/A Mental Health - Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders Mental, Behavioral and Neurodevelopmental disorders Feed
Specific (isolated) phobia is a persistent, intense, and irrational fear of specific objects or situations.
Not applicable. ICD-10-CM codes do not utilize modifiers.
Medical necessity for treatment of specific phobia is established when the phobia causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, as judged by a qualified mental health professional.The intensity and duration of the phobia, impact on daily life, and the need for intervention to improve the patient's quality of life all support the medical necessity for treatment.Payer-specific criteria and guidelines should also be considered.
Diagnosis and treatment of specific phobias are typically the responsibility of mental health professionals such as psychiatrists, psychologists, or other qualified healthcare providers specializing in anxiety disorders.This includes conducting thorough assessments, developing personalized treatment plans (often involving CBT and exposure therapy), and monitoring patient progress.In some cases, medication may be prescribed to manage symptoms.
In simple words: A specific phobia is a strong and ongoing fear of something that isn't actually dangerous.This fear can cause significant anxiety and make it hard to do everyday things. For example, someone might have a phobia of spiders, heights, or flying.Treatment usually involves talking to a therapist and gradually facing the things that cause fear.
Specific (isolated) phobias involve marked and persistent fear or anxiety about a specific object or situation (e.g., animals, insects, heights, enclosed spaces, thunderstorms, blood, injections, injury).Exposure to the phobic stimulus almost always provokes an immediate anxiety response, which may escalate to a panic attack. Individuals with specific phobias recognize that their fear is excessive or unreasonable. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.The duration of the disturbance is typically six months or more.Treatment commonly involves cognitive behavioral therapy (CBT) and exposure therapy, possibly supplemented with medication such as beta-blockers or sedatives in certain situations.
Example 1: A patient presents with an intense and persistent fear of spiders (arachnophobia), causing significant distress and avoidance of situations where spiders might be present. Treatment includes CBT to address underlying cognitive distortions and exposure therapy involving gradual exposure to spiders in a controlled setting., A patient experiences debilitating fear of flying (aviophobia), interfering with both personal and professional travel.Treatment involves graded exposure therapy, starting with imagining flying and progressing to taking short flights, and then longer ones, combined with relaxation techniques and CBT to challenge anxiety-provoking thoughts., A patient with a phobia of blood and needles (hemophobia) avoids necessary medical procedures such as blood tests and vaccinations.Exposure therapy, starting with visual imagery and progressing to increasingly close contact with needles and sights of blood, alongside CBT, helps the patient overcome avoidance behavior.
A complete medical history including the onset, duration, and severity of the phobia;a detailed description of the phobic stimulus and the patient's response (e.g., anxiety symptoms, avoidance behaviors); results of any relevant psychological assessments; treatment plan outlining therapeutic interventions (CBT, exposure therapy, medication if applicable); and documentation of patient progress during and after treatment.
** Specific phobias are commonly comorbid with other mental health conditions.Comorbidity should be documented and coded appropriately.The severity of the phobia and its impact on the individual’s life should be carefully considered when determining the appropriate level of care and treatment.
- Payment Status: Active
- Modifier TC rule: Not applicable.ICD-10-CM codes do not utilize modifiers.
- Specialties:Psychiatry, Psychology, Clinical Psychology
- Place of Service:Office, Outpatient Hospital, Mental Health Clinic, Inpatient Hospital (if hospitalized for comorbid conditions)