ICD-10 code for panic disorder
This article provides an overview of the situational anxiety ICD-10 code, including the diagnostic criteria, differential diagnoses, anxiety and depression coding guidelines, and when to use the situational stress ICD-10 code.
Understanding ICD-10 codes, such as the situational anxiety ICD-10 code, is important for mental health clinicians in making an efficient diagnosis, treatment planning, and billing.
Using the right codes avoids potential hiccups with insurance companies.
What is the situational anxiety ICD-10 code?
While F40.24 “Situational type phobia” is the situational anxiety ICD-10 code, it should not be used for insurance reimbursement purposes, as there are multiple codes in the F40 category (“Phobic anxiety disorders”) that contain a greater level of detail, which we’ll get into below.
Similarly, there is no single "situational stress" ICD-10 code, but several codes fall under the F43 category (“Reaction to severe stress and adjustment disorders”), including F43.0 for acute stress reaction and F43.2 for adjustment disorders.
For insurance reimbursement purposes, there are specific social and situational phobias which fall under the broader anxiety disorders umbrella, or codes F40-F48 for “Anxiety, dissociative, stress-related, somatoform, and other nonpsychotic mental disorders” that can be used.
They appear in the ICD-10 diagnostic tree as follows under the F40 category:
F40: Phobic anxiety disorders
F40.1: Social anxiety disorder (social phobia)
F40.10: Social anxiety disorder, unspecified
F40.11: Social anxiety disorder, generalized
F40.2: Specific (isolated) phobias, including situational type:
F40.240: Claustrophobia
F40.241: Acrophobia (fear of heights)
F40.242: Fear of bridges
F40.243: Fear of flying
F40.248: Other situational type phobia
F40.8: Other phobic anxiety disorders
F40.9: Phobic anxiety disorder, unspecified
It is common to have multiple specific phobias, with 75% of those with a specific phobia experiencing fearfulness about more than one object or situation.
Situational anxiety or phobia diagnostic criteria
The diagnostic criteria for specific anxiety-related phobias includes:
Marked fear or anxiety about a specific object or situation (e.g., flying, heights, animals, receiving an injection, or seeing blood).
The phobic object or situation almost always provokes immediate fear or anxiety.
The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
The phobic object or situation is actively avoided or endured with intense fear or anxiety.
The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The fear, anxiety, or avoidance is persistent, typically lasting for six months or longer.
The disturbance is not better explained by the symptoms of another mental disorder, including fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia); objects or situations related to obsessions (as in obsessive-compulsive disorder); reminders of traumatic events (as in post-traumatic stress disorder); separation from home or attachment figures (as in separation anxiety disorder); or social situations (as in social anxiety disorder).
When using this situational anxiety ICD-10 code, you would list the names and specific codes of all phobias.
Situational anxiety versus acute stress, social anxiety, and adjustment disorder
When coding for situational anxiety for insurance reimbursement, it's important to first differentiate it from similar conditions that have distinct ICD-10 codes, and then to use the codes for the specific situational type.
Situational anxiety, coded as a specific phobia under F40.24, is characterized by persistent fear or anxiety triggered by particular situations or objects.
In contrast, acute stress reaction (F43.0) develops as a direct response to a traumatic or overwhelming event and typically occurs within one month of the stressor. The key distinction is that situational anxiety or the situational stress ICD-10 code involves anticipatory fear of specific circumstances, while acute stress reaction is a time-limited response to trauma.
Social anxiety disorder has its own distinct ICD-10 code (F40.10) and differs from situational-specific phobias.
While both involve fear in certain contexts, social anxiety disorder specifically involves fear of social situations where the individual may be observed or judged by others, along with concerns about behaving in ways that could lead to negative evaluation. Situational anxiety is broader and may include non-social situations.
Adjustment disorder with anxiety (F43.22) or mixed anxiety and depressed mood (F43.23) develops in response to an identifiable stressor within three months of its onset. Unlike situational anxiety, which involves a persistent phobic response to specific situations, adjustment disorder represents difficulty adapting to a life change or stressful event. The symptoms in adjustment disorder are generally time-limited and resolve within six months after the stressor or its consequences end.
Differential diagnosis for anxiety-related phobias
Even though clients may meet some criteria for phobia anxiety disorder or related situational anxiety ICD-10 codes, there may be a more appropriate diagnosis, such as:
Social anxiety disorder
Agoraphobia
Separation anxiety disorder
Panic disorder
Eating disorders
Schizophrenia spectrum and psychotic disorders
Trauma-and-stressor-related disorders
Other common anxiety ICD-10 codes
Anxiety disorders are some of the most frequently billed ICD-10 codes by mental health clinicians, according to our article on the 20 most commonly billed ICD-10 codes.
For example, the ICD-10 code for anxiety unspecified, F41.9, is at #5 on the list, demonstrating how commonly clients seek therapy for anxiety-related conditions.
Some other common anxiety-related ICD-10 codes include:
F41.0: Panic disorder
F41.1: Generalized anxiety disorder
F41.3: Other mixed anxiety disorders
F41.8: Other specified anxiety disorders
F41.9: Anxiety disorder, unspecified
What is the ICD-10 for situational depression?
Similar to the situational stress ICD-10 code and the situational anxiety ICD-10 code, there isn’t one specific situational depression code.
Situational depression could be described as an adjustment disorder, or it could have a depression with anxiety ICD-10 code.
ICD-10 codes frequently used to diagnose depression are F32 and F33. F32 denotes singular episodes of depression, whereas F33 describes recurrent depressive disorders.
Singular episode of depression ICD-10 codes
F32: Depressive episode
F32.0: Major depressive disorder, single episode, mild
F32.1: Major depressive disorder, single episode, moderate
F32.2: Major depressive disorder, single episode, severe without psychotic features
F32.3: Major depressive disorder, single episode, severe with psychotic features
F32.4: Major depressive disorder, single episode, in partial remission
F32.5: Major depressive disorder, single episode, in full remission
F32.81: Premenstrual dysphoric disorder
F32.89: Other specified depressive episodes
F32.9: Major depressive disorder, single episode, unspecified
F32.A: Depression, unspecified
Recurrent depressive episodes ICD-10 codes
F33: Major depressive disorder, recurrent
F33.0: Major depressive disorder, recurrent, mild
F33.1: Major depressive disorder, recurrent, moderate
F33.2: Major depressive disorder, recurrent severe without psychotic features
F33.3: Major depressive disorder, recurrent, severe with psychotic symptoms
F33.4: Major depressive disorder, recurrent, in remission
F33.40: Major depressive disorder, recurrent, unspecified
F33.41: Major depressive disorder, recurrent, in partial remission
F33.42: Major depressive disorder, recurrent, in full remission
F33.8: Other recurrent depressive disorders
F33.9: Major depressive disorder, recurrent, unspecified
How to find the right diagnosis code for anxiety
You can find the anxiety and depression ICD-10 coding guidelines and more specific diagnostic information in the following digital ICD-10 and DSM-5 formats:
ICD-10 Data, a searchable ICD-10 database
The WHO’s version of the ICD-10, section 5 Mental and behavioral disorders, under the subheading F40-F48 “Neurotic, stress-related and somatoform disorders”
DSM-5 throughout the textbook and online. The hard copy contains a handy alphabetical list and numerical list of ICD-10 codes
Please note while the DSM-5 does contain accurate situational stress ICD-10 codes and situational anxiety ICD-10 codes, they may not align with the most recent ICD version, diagnostic criteria, and other indicators.
How SimplePractice streamlines running your practice
SimplePractice is HIPAA-compliant practice management software with everything you need to run your practice built into the platform—from booking and scheduling to insurance and client billing.
If you’ve been considering switching to an EHR system, SimplePractice empowers you to run a fully paperless practice—so you get more time for the things that matter most to you.
Try SimplePractice free for 30 days. No credit card required.
