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F41.0·CIM-10-CM

Panic Disorder Without Agoraphobia

Recurrent unexpected panic attacks with at least one month of persistent concern about additional attacks or significant maladaptive behavioral change.

Outil de dépistage recommandé

Outil de dépistage validé
Panic Disorder Severity Scale (PDSS)

DSM-5-TR diagnostic criteria summary

Panic Disorder requires:

  • Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes, with ≥4 of 13 symptoms: palpitations, sweating, trembling, shortness of breath, choking sensation, chest pain, nausea, dizziness, chills/heat, paresthesias, derealization/depersonalization, fear of losing control, fear of dying.
  • At least one attack followed by ≥1 month of:
  • Persistent concern about additional panic attacks or their consequences (e.g., losing control, "going crazy," having a heart attack), or
    • Significant maladaptive behavioral change related to attacks (e.g., avoidance of exercise, unfamiliar situations).
    • Not better explained by another mental disorder (panic in social situations only would be social anxiety; panic following a trauma cue would be PTSD).

    Source: American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), p. 235–242.

    Validated severity scale Panic Disorder Severity Scale (PDSS)

    Score range0–28 (7 items rated 0–4) Cutoff≥7 indicates clinically significant panic disorder DomainsFrequency, distress, anticipatory anxiety, avoidance, impairment VersionsPDSS (clinician), PDSS-SR (self-report)

    Co-administer the GAD-7 and PHQ-9 to screen for high-comorbidity generalized anxiety and depression presentations. Routine PHQ-9 administration captures elevated suicide risk that often co-occurs with panic disorder.

    Differential diagnosis

    • F40.00 / F40.01 Agoraphobia (with Panic Disorder), when agoraphobia symptoms are present, code may shift; both can be co-coded.
    • F41.1 Generalized Anxiety Disorder, chronic worry without discrete panic episodes.
    • F40.10 Social Anxiety Disorder, panic occurs only in feared social situations (situational, not unexpected).
    • F43.10 PTSD, panic-like symptoms triggered by trauma reminders.
    • Substance/Medication-Induced, caffeine, stimulants, alcohol/benzodiazepine withdrawal.
    • Medical conditions, hyperthyroidism, pheochromocytoma, cardiac arrhythmias (mitral valve prolapse, SVT), pulmonary embolism, hypoglycemia. ED workup typically rules these out.

    Common comorbidities

    Panic Disorder has very high lifetime comorbidity. Common co-occurring conditions: Generalized Anxiety Disorder (F41.1), Major Depressive Disorder (F33, F32), Agoraphobia (F40.00), Substance Use Disorders (F10–F19), and Bipolar Disorders (F31.x). Routinely co-administer PHQ-9, GAD-7, and AUDIT alongside the PDSS.

    Sources

    • American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), F41.0, p. 235–242.
    • Shear, M. K., et al. (1997). Multicenter collaborative panic disorder severity scale. American Journal of Psychiatry, 154(11), 1571–1575.
    • Centers for Disease Control and Prevention. ICD-10-CM Official Coding Guidelines.

    Foire aux questions

    What is ICD-11 code F41.0?

    F41.0 is the ICD-11-CM code for Panic Disorder Without Agoraphobia, recurrent unexpected panic attacks with at least one month of persistent concern about additional attacks or maladaptive behavioral change. When agoraphobia is also present, F40.01 (Agoraphobia With Panic Disorder) may apply.

    What are the diagnostic criteria for F41.0?

    DSM-5-TR Panic Disorder requires recurrent unexpected panic attacks (abrupt surge of intense fear/discomfort with ≥4 of 13 physical/cognitive symptoms peaking within minutes), AND at least one attack followed by ≥1 month of either persistent concern about additional attacks/their consequences, or significant maladaptive behavior change related to attacks. Symptoms must not be substance-induced or due to another medical condition.

    What scale is used to screen for F41.0?

    The Panic Disorder Severity Scale (PDSS) is a 7-item clinician-rated scale measuring panic frequency, distress, anticipatory anxiety, and functional impairment (range 0–28; cutoff ≥7 for clinical significance). The GAD-7 and PHQ-9 are routinely co-administered to screen for the high comorbidity. A positive screen warrants a full clinical evaluation.

    What is a panic attack vs a panic disorder?

    A panic attack is a discrete episode of intense fear with sudden physiological and cognitive symptoms, many people experience one or more panic attacks without developing the disorder. Panic Disorder (F41.0) requires recurrent unexpected attacks plus persistent concern or behavioral change for at least one month. DSM-5-TR added 'panic attack' as a specifier that can apply to many conditions (e.g., 'major depressive disorder with panic attacks').

    How is F41.0 different from F41.1?

    F41.0 is Panic Disorder, characterized by recurrent unexpected panic attacks with persistent concern about additional attacks. F41.1 is Generalized Anxiety Disorder, characterized by chronic, pervasive worry across multiple domains. Many patients meet criteria for both; they are coded separately when present.

    Is F41.0 a billable ICD-11-CM code?

    Yes, F41.0 is a billable ICD-11-CM code as of the 2025 official tabular list. It is the standard reimbursed code for Panic Disorder without agoraphobia. When agoraphobia is also present, F40.01 (Agoraphobia with panic disorder) is used instead, and F40.02 (Agoraphobia without panic disorder) covers agoraphobia alone.

    What are the symptoms of panic disorder?

    Panic disorder produces recurrent unexpected panic attacks plus persistent worry about additional attacks. A panic attack is an abrupt surge of intense fear that peaks within minutes and includes at least four physical or cognitive symptoms: heart palpitations, sweating, trembling, shortness of breath, choking sensation, chest pain, nausea, dizziness, chills or hot flashes, numbness or tingling, derealization, fear of losing control, or fear of dying. Many people then avoid situations where attacks have happened.

    How is panic disorder diagnosed?

    Panic disorder is diagnosed by a clinician using DSM-5-TR criteria, which require recurrent unexpected panic attacks plus at least one month of persistent concern about additional attacks or maladaptive behavior change. Diagnosis typically follows a positive PDSS or screen, structured clinical interview, medical workup to rule out cardiac, thyroid, and pulmonary causes, and screening for comorbid depression and substance use.

    What causes panic disorder?

    Panic disorder arises from a combination of genetic, neurobiological, and environmental factors. Heritability estimates from twin studies range from 30% to 50%. Neurobiological contributors include heightened amygdala and locus coeruleus reactivity, altered serotonin and norepinephrine signaling, and CO2 sensitivity in respiratory control. Environmental triggers include early-life adversity, recent major stress, separation events, and substance use (caffeine, stimulants, cannabis).

    Can panic disorder be cured?

    Panic disorder is highly treatable and many patients achieve full or substantial remission. Cognitive behavioral therapy with interoceptive exposure is the first-line treatment, with 70% to 90% of patients showing significant improvement and many becoming panic-free. SSRIs and SNRIs are first-line medications; benzodiazepines are reserved for short-term use. Without treatment, panic disorder tends to be chronic and increases risk of agoraphobia, depression, and alcohol use.

    How is F41.0 different from… · Is F41.0 a billable ICD-11-CM… · What are the symptoms of… · How is panic disorder diagnosed
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