F40.00 — Agoraphobia, unspecified
F40.00 is a billable, specific ICD-10-CM code for agoraphobia, unspecified. It is valid for submission on a claim.
Risk adjustment
F40.00 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
F40.00 is named in 11 Medicare coverage policies — 10 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
- A56756Billing and Coding: Home Health - Psychiatric Care
- A56937Billing and Coding: Psychiatry and Psychology Services
- A56937Billing and Coding: Psychiatry and Psychology Services
How F40.00 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 F40.00.
- Agoraphobia
Related codes at this level
Codes that share F40.0. If F40.00 is not quite right, the correct code is usually one of these.
Questions about F40.00
- Is F40.00 a billable ICD-10-CM code?
- Yes. F40.00 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does F40.00 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).