Since Halloween is this week, it is a good time to talk about what scares us. I’m not talking about a masked character with a machete or a ghoulish figure that haunts you – I’m thinking of phobias we can assign for in ICD-10-CM.
Agoraphobia, according to the Mayo Clinic, is a type of anxiety disorder. Those who suffer from agoraphobia may feel that they can’t leave their home because they are afraid of being somewhere where they feel trapped – they avoid situations that cause panic or make them feel helpless.
Treatment with cognitive behavioral therapy and medication can help. We assign F40.00 for Agoraphobia, unspecified, or F40.01 for Agoraphobia with panic disorder.
Social phobias are assigned to F40.1- this includes anthropophobia, or a fear of people. Cleveland Clinic notes that while this is not included as a clinical disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is considered a specific phobia by many. It also notes that unlike other social anxiety disorders, here the phobia involves people themselves, not the social interaction with them.
Arachnophobia, the fear of spiders, is assigned to F40.210. Cleveland Clinic again notes this is an irrational and intense fear that interferes with a patient’s daily life. F40.218 would be assigned for other animal-type phobia; this could mean black cats, or maybe even vampire bats.
F40.220 would be assigned for fear of thunderstorms. Astraphobia is the name for the fear of thunder and lightning. Staying with Cleveland Clinic as our reference here, it notes that astraphobia typically affects children and is one of the most common specific phobias. F40.228 would be assigned for Other natural environment-type phobia.
F40.23 would be for blood, injection, and injury-type phobia codes. We have F40.230 for fear of blood, or hemophobia. Those suffering from hemophobia would probably want to avoid the scary movies that are so popular this month. F40.231 would be assigned for fear of injections and transfusions. F40.232 is for fear of other medical care, and finally we have F40.233 for fear of injury. It is important to remember that when we are talking about phobias, these are intense, irrational fears that have the ability to affect the patient’s life.
F40.24 is where we would find codes for situational-type phobias. F40.240 is our code for claustrophobia. We are familiar with this as the fear of confined or enclosed spaces. Next up is F40.241 for acrophobia – or fear of heights. Cleveland Clinic notes that this is one of the most common phobias. It notes that most people feel a little uneasy looking down from a high position, while those with acrophobia may encounter difficulties with climbing stairs or being near a balcony.
Fortunately, treatment options are available, including using virtual reality to expose those with acrophobia to situations in a safe, controlled environment. F40.242 is for fear of bridges, or gephyrophobia, and F40.243 is for fear of flying, or aerophobia. According to Cleveland Clinic, aerophobia affects about 25 million adults in the United States; the publication notes that psychotherapy helps patients fly without experiencing panic attacks.
Code F40.248 is for other situational-type phobia and would be assigned when a specific situational phobia is documented, but there is no other specific code that applies.
I hope everyone has a very Happy Halloween – and finally, as a reminder, when you follow your coding guidelines, there is nothing to fear.
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