F41.0 — Panic Disorder

Clinical Description

F41.0 represents panic disorder, defined by recurrent unexpected panic attacks accompanied by persistent concern about future attacks or maladaptive behavioral changes. Documentation must capture the nature of panic attacks and their impact on functioning.

Key Symptoms to Document

When using F41.0, your documentation should reference these symptoms:

• Recurrent unexpected panic attacks with abrupt surges of intense fear
• Palpitations, pounding heart, or accelerated heart rate
• Shortness of breath or sensation of smothering
• Chest pain or discomfort
• Persistent worry about having additional attacks
• Avoidance of situations associated with panic attacks

Common Interventions to Document

Evidence-based interventions typically documented with this diagnosis:

• Cognitive Behavioral Therapy (CBT) with interoceptive exposure
• Panic-focused psychoeducation
• SSRI pharmacotherapy (e.g., sertraline, paroxetine)
• Breathing retraining and relaxation techniques
• Graded exposure to feared situations

CPT Code Pairings

Common CPT codes used when billing with F41.0:

• 90791 — Psychiatric diagnostic evaluation
• 90834 — Individual psychotherapy, 45 minutes
• 90837 — Individual psychotherapy, 60 minutes
• 96127 — Brief emotional/behavioral assessment
• 99214 — Office visit, moderate complexity

Documentation Tips

• Document the frequency, duration, and intensity of panic attacks, including specific somatic symptoms experienced.
• Note whether attacks are expected (cued) or unexpected (uncued); DSM-5 requires at least some unexpected attacks.
• Record the degree of anticipatory anxiety and any avoidance behaviors between attacks.
• Document cardiac or medical workup results to rule out medical causes of symptoms.
• Track severity using the Panic Disorder Severity Scale (PDSS) or similar measure.

Differential Diagnosis Considerations

When documenting F41.0, consider and rule out:

• Generalized anxiety disorder (F41.1)
• Social anxiety disorder (F40.10)
• Specific phobia (F40.2xx)
• Cardiac arrhythmia or mitral valve prolapse
• Hyperthyroidism
• Substance/medication-induced anxiety disorder

Screening Tools

Standardized measures commonly used with this diagnosis:

• Panic Disorder Severity Scale (PDSS)
• GAD-7 (Generalized Anxiety Disorder scale)
• PHQ — Panic Disorder Module
• Agoraphobic Cognitions Questionnaire (ACQ)
• Body Sensations Questionnaire (BSQ)