ICD-10-CM: Know Which Terms Lead to Codes for Generalized Anxiety Disorder and Panic Disorder

Tue, Nov 27, 2018 --

ICD-10, Skill Sharpener

diagnosis coding for generalized anxiety disorder

Generalized anxiety disorder and panic disorder rank among the most common mental health disorders in the U.S. population. A variety of health professionals may see patients with these conditions, including primary care providers and specialists. That means knowing the diagnosis coding terminology below is beneficial for a lot of us in the field.

Starting point: Both of our mental health diagnoses-in-focus are in the “other” category F41.- (Other anxiety disorders), but they have unique ICD-10-CM codes.

Use F41.0 for Panic Disorder and These Related Terms

For panic disorder, you’ll use F41.0 (Panic disorder [episodic paroxysmal anxiety]). This code is also appropriate when documentation specifies panic attack or panic state, according to notes with F41.0 in ICD-10-CM.

Index: The ICD-10-CM Index points you to F41.0 for these terms:

  • Anxiety, episodic paroxysmal
  • Anxiety, panic type
  • Attack, attacks, panic
  • Disorder (of), panic
  • Neurosis, neurotic, anxiety (state), panic type
  • Panic (attack) (state)
  • State (of) panic.

Add Apprehension to the List for GAD Terms

For generalized anxiety disorder (GAD), you should report F41.1 (Generalized anxiety disorder). The additional terms listed with this code in the Tabular are below:

  • Anxiety neurosis
  • Anxiety reaction
  • Anxiety state
  • Overanxious disorder.

Index: In the ICD-10-CM Index, F41.1 is listed with these entries. Many of them are variations of what’s in the Tabular, but note the references to apprehension state, as well:

  • Anxiety, generalized
  • Anxiety, neurosis
  • Anxiety, reaction
  • Anxiety, state
  • Apprehension state
  • Disorder (of), anxiety, generalized
  • Disorder, overanxious
  • Neurosis, neurotic, anxiety (state)
  • Psychoneurosis, psychoneurotic, anxiety (state)
  • Reaction, anxiety
  • State (of), anxiety (neurotic)
  • State (of), apprehension.

Know When to Look Elsewhere for Codes

The list of diagnoses coded to F41.0 and F41.1 may look long, but you know we can’t make assumptions when it comes to coding. Some similar sounding conditions are reported using other codes.

There is an Excludes2 note for the entire F41.- category listing these conditions:

  • Anxiety in:
    • acute stress reaction (F43.0)
    • transient adjustment reaction (F43.2)
    • neurasthenia (F48.8)
    • psychophysiologic disorders (F45.-)
    • separation anxiety (F93.0).

Additionally, panic disorder code F41.0 has an Excludes1 note for panic disorder with agoraphobia (F40.01).

Even though F41.- already has an Excludes2 note for neurasthenia, F41.1 lists an identical Excludes2 note again at code level: neurasthenia (F48.8).

Have This HCC Hint Handy

For both F41.0 and F41.1, the RXHCC code is RXHCC135 with the description of Anxiety Disorders.

What About You?

Do you find that your providers’ documentation matches the code language for these mental health conditions?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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