F40.01 — Agoraphobia with panic disorder
F40.01 is a billable, specific ICD-10-CM code for agoraphobia with panic disorder. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- panic disorder without agoraphobia (F41.0)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Panic disorder with agoraphobia
Other codes that can never be billed with F40.01
These codes carry an Excludes1 note pointing at F40.01. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading F40.01 alone.
- F41.0Panic disorder [episodic paroxysmal anxiety]
Risk adjustment
F40.01 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
F40.01 is named in 33 Medicare coverage policies — 32 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52434Health and Behavior Assessment/Intervention – Medical Policy Articlenot covered
- A56614Billing and Coding: Psychiatric Inpatient Hospitalization
- A56756Billing and Coding: Home Health - Psychiatric Care
- A56850Billing and Coding: Psychiatric Partial Hospitalization Programs
How F40.01 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to F40.01.
- Agoraphobia›with panic disorder
- Disorder›panic›with agoraphobia
Related codes at this level
Codes that share F40.0. If F40.01 is not quite right, the correct code is usually one of these.
Questions about F40.01
- Is F40.01 a billable ICD-10-CM code?
- Yes. F40.01 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F40.01 sit in the tabular list?
- Mental, Behavioral and Neurodevelopmental disorders (F01-F99), in the block Anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (F40-F48).
- What cannot be coded together with F40.01?
- F40.01 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.