A) Marked fear or anxiety about a specific object or situation (e.g., flying, heights, and animals, receiving an injection, seeing blood).
Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, or clinging.
B) The phobic object or situation almost always provokes immediate fear or anxiety.
C) The phobic object or situation is actively avoided or endured with intense fear or anxiety.
D) The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
E) The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.
F) The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
G) The disturbance is not better explained by the symptoms of another mental disorder, including fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia); objects or situations related to obsessions (as in obsessive-compulsive disorder); reminders of traumatic events (as in separation anxiety disorder); or social situations (as is social anxiety disorder).
Code based on the phobic stimulus: Like animal (e.g. Spiders, insects, dogs)
Natural environment (e.g. Heights, storm, water)
Blood-injection-injury (e.g. Needles, invasive medical procedures)
Situational (e.g. Aeroplanes, elevators, enclosed spaces)
Other. (E.g. Situations that may lead to choking or vomiting, in children such as loud sounds or costume characters)
Coding note: When more than one phobic stimulus is present, code all ICD-10-CM codes that apply (e.g., fear of snakes and flying, F40.218 specific phobia, animal, and specific phobia, situational).