Quick reference
- When to use
- Use F40.00 when the client presents with symptoms consistent with Agoraphobia that cause clinically significant distress or functional impairment, and the presentation is not better explained by another mental disorder, substance use, or medical condition.
- Duration
- Symptoms must be present for at least 6 months. Reassess severity and diagnosis at regular intervals. Update code if symptoms remit or change in character.
- Session codes
- Pair with CPT 90791 (initial evaluation), 90834 (45-min therapy), 90837 (60-min therapy), or 90847 (family therapy). Add 90785 for interactive complexity. Use 96127 for standardized screening (e.g., GAD-7).
- Key indicators
- Excessive worry or fear disproportionate to actual threat • Avoidance behaviors • Physical symptoms (muscle tension, restlessness, fatigue) • Functional impairment in work, social, or daily activities
What F40.00 represents
Agoraphobia involves marked fear or anxiety about two or more of five situations: using public transportation, being in open spaces, being in enclosed places, standing in line or being in a crowd, or being outside the home alone. The fear is disproportionate and leads to avoidance.
Key diagnostic criteria
- Fear/anxiety about 2+ of 5 situation types
- Fear that escape is difficult or help unavailable
- Situations almost always provoke fear
- Active avoidance, companion needed, or endured with intense distress
- Out of proportion to actual danger
- Persistent (typically 6+ months)
- Clinically significant distress/impairment
Documentation essentials
Document specific situations feared and avoided. Record the degree of avoidance and its impact on daily functioning. Note whether a companion is required.
Differential diagnosis
Distinguish from specific phobia (limited to one situation), social anxiety (fear of scrutiny), PTSD (avoidance of trauma reminders), and separation anxiety.
Treatment planning
In vivo exposure therapy is the gold standard. CBT, virtual reality exposure, and SSRIs are all evidence-based options.
Insurance & billing
Well-accepted code. Document functional limitations clearly.
Updates & changes
DSM-5 separated agoraphobia from panic disorder as an independent diagnosis.
Documentation pitfalls
Don't assume agoraphobia always co-occurs with panic disorder. Document the specific situations avoided.
References
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).