300. 22 Agoraphobia Diagnosis (F40.00):
Agoraphobia is a diagnosis recently codable according to the new DSM-5 (Diagnostic And Statistical Manual Fifth Edition) published by the American Psychiatric Association. The agoraphobia diagnosis is given when you experience a high level of fear from either real or imagined exposure to specific circumstances or situations. It is most frequently experienced by teens and middle-aged adults in the U.S. with a prevalence rate of 1.7%. It is rarely initially experienced among seniors and young children. If you receive a diagnosis of agoraphobia, you may have anywhere from a moderate to severe level of impairment in your activities of daily living. It has been noted that approximately 33% of people diagnosed with this anxiety disorder feel restricted to their homes.
Agoraphobia Diagnosis: Key Features
Some of the primary aspects of agoraphobia are that you feel fear in situations in which you believe you cannot escape or in which you believe that bad things can happen to you beyond your control. The fear can vary according to your experience with the actual situation or even may occur in anticipation of the circumstance. This response must occur every time you have experience with the situation. An agoraphobia diagnosis cannot be given if you only experience the fear and potential avoidance occasionally. Agoraphobia usually results in avoidance of that situation and may affect both your thinking and behaviors.
An agoraphobia diagnosis can be given whether you meet the criteria or not for a . If the criteria is met for both disorders, you may be given a diagnosis for both. This is a very intense, disabling diagnosis frequently resulting in an individual becoming homebound. An initial agoraphobia diagnosis is rare among children and seniors with a mean age of onset of 17 years old. It usually shows its first signs in the teen and middle-aged years. There are some gender-related differences in that females are about twice as likely to have agoraphobia as males. In most cases if you have a agoraphobia diagnosis you most often experience comorbid mental health disorders such as anxiety and depression. In most cases if you meet the criteria of both agoraphobia and another diagnosis, both diagnoses are given.
Agoraphobia is typically treated within the context of panic disorder. Additional information related to agoraphobia symptoms and treatments may be found on additional pages of this website.
Coding for a Agoraphobia Diagnosis:
Coding for Agoraphobia diagnosis is 300.22 (F40.00). Also, a specifier with panic attacks is often given in conjunction with a diagnosis of agoraphobia.
More specific agoraphobia diagnostic criteria follow below.
Agoraphobia diagnostic criteria 300.22 (F40.00):
A. Marked fear or anxiety about two (or more) of the following five situations:
1. Using public transportation such as automobiles, buses, trains, ships or planes.
2. Being in open spaces such as parking lots, marketplaces or bridges.
3. Being in enclosed places such as shops, theaters, or cinemas.
4. Standing in line or being in a crowd.
5. Being outside of the home alone.
B. The individual fears or avoids these situations because of the thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms such as fear of falling in the elderly or fear of incontinence.
C. The Agoura phobic situations almost always provoke fear or anxiety.
D. The agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety.
E. The fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and to the sociocultural context.
F. The fear, anxiety, or avoidance is persistent, typically lasting for six months or more.
G. The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
H. If another medical condition such as inflammatory bowel disease or Parkinson’s disease is present, the fear, anxiety, or avoidance is clearly excessive
I. The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, for example, the symptoms are not confined to specific phobia, situational type; do not involve only social situations as in social anxiety disorder; and are not related exclusively to obsessions as in obsessive-compulsive disorder, perceived effects of flaws in physical appearance as in body dysmorphic disorder, reminders of traumatic events as in posttraumatic stress disorder, or fear of separation as in separation anxiety disorder.
Note: Agoraphobia is diagnosed irrespective of the presence of panic disorder. If an individual’s presentation meets criteria for panic disorder and Agoraphobia, both diagnosis should be assigned.
Diagnostic Information and Criterion adapted from the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition American Psychological Association by Paul Susic Ph.D. Licensed Psychologist