F43.22 at a glance
F43.22 | |
|---|---|
Official description | Adjustment disorder with anxiety |
Billable | Yes, in the FY2027 code set (effective October 1, 2026) |
Parent code | F43.2, Adjustment disorders (a header, not billable on its own) |
Category | F43, Reaction to severe stress, and adjustment disorders |
Inclusion terms at F43.2 | Culture shock; grief reaction; hospitalism in children |
Excludes2 (F43.2) | Separation anxiety disorder of childhood (F93.0) |
Changed in FY2027 | No |
Adjustment disorder with anxiety in ICD-10: how the index gets to F43.22
In the ICD‑10‑CM Alphabetic Index, there is one route to F43.22: Disorder, adjustment, with anxiety. Stop at "adjustment" and the index gives F43.20, adjustment disorder, unspecified. Go one level deeper, to "with anxiety, with depressed mood", and it gives F43.23.
The anxiety entries are where claims go wrong. "Anxiety reaction" and "anxiety state" don't lead to an adjustment code at all. Both index to F41.1, generalized anxiety disorder, and "anxiety" on its own indexes to F41.9. A diagnosis line like "anxiety reaction to job change" can therefore be coded as GAD by someone working from the words. When you mean an adjustment disorder, write "adjustment disorder with anxiety" in the assessment.
F43.22 vs F41.1, F41.9 and other close codes
What the note describes | Code |
|---|---|
Adjustment disorder after a stressor, anxiety the main feature | F43.22 |
Adjustment disorder with anxiety and prominent low mood | F43.23 |
Adjustment disorder, subtype not documented | F43.20 |
Generalized anxiety disorder, or "anxiety reaction" or "anxiety state" | F41.1 |
Anxiety with no further detail | F41.9 |
Post-traumatic stress disorder, acute or chronic not stated | F43.10 |
Separation anxiety disorder of childhood | F93.0 |
The F41 category has an Excludes2 note for anxiety in a transient adjustment reaction (F43.2). Read plainly, anxiety that is part of an adjustment disorder is coded F43.22, not from F41. Since it's an Excludes2 and not an Excludes1, the code set doesn't bar an F41 code on the same claim, but that needs a separate anxiety disorder in the note that the stressor doesn't account for.
Related pages: F43.20, F43.21, F43.23, F41.1, F41.9 and F43.10.
When F43.22 is the right code
The typical F43.22 client can name the day it started. A move, a new job, a family member's diagnosis, a lawsuit: the worry follows the stressor, and before it the client wasn't anxious in this way. If the anxiety predates the event or spreads well beyond it, an F41 code is usually the better description.
Culture shock is one of the inclusion terms listed under F43.2, and the index entry "Shock, culture" sends you back to Disorder, adjustment. An international student whose anxiety began with the move and dominates the picture can be coded F43.22. When there's no disorder, only a hard time settling into a new culture, Z60.3 (acculturation difficulty) records it as a circumstance instead.
With children, think about separation anxiety. F43.2 lists separation anxiety disorder of childhood (F93.0) as an Excludes2, so a child who develops both after a parent is deployed can carry F43.22 and F93.0 when both are diagnosed. Z63.31, absence of family member due to military deployment, can record the stressor.
What to document for F43.22
- The stressor and its date, in concrete terms: "moved from Ohio in August", not "life changes".
- When the anxiety began relative to that date.
- The anxiety symptoms you observe and the client reports, and what they get in the way of at work, school or home.
- One line on why another anxiety disorder doesn't explain it better, such as no earlier anxiety history.
- A GAD-7 or similar score with its date, if you use one.
A fictional client shows how that reads in practice:
Example. Client, 29, moved from Ohio to Denver eight weeks ago for a partner's job and has not found work yet. No anxiety history before the move. Reports near‑constant worry about money and job applications, restlessness, and waking at 3 a.m. most nights since August. GAD‑7 is 12 today. Describes mood as "frustrated but okay" and still enjoys weekend hikes. Assessment: adjustment disorder with anxiety (F43.22); Z56.0, unemployment. Plan: weekly CBT targeting worry, repeat GAD‑7 in four weeks.
The tabular doesn't require a Z code with F43.2, but a stressor code such as Z56.0 or Z60.3 tells a reviewer what the client is adjusting to. For checking AI‑drafted notes before you sign, see our guide to writing therapy progress notes in DAP, BIRP or GIRP.
Billing F43.22
F43.22 names the condition; the CPT code names the service. In outpatient therapy it's usually paired with these:
CPT code | When it's used with F43.22 |
|---|---|
90791 | The intake evaluation where the adjustment disorder is diagnosed |
90832, 90834, 90837 | Individual psychotherapy, chosen by the time spent |
96127 | A scored brief measure such as the GAD-7 |
Details on each: 90791, 90832, 90837 and 96127.
CPT is a registered trademark of the American Medical Association. CPT codes copyright 2026 American Medical Association. All rights reserved.
Common mistakes with F43.22
- Letting the word "anxiety" drive the code. "Anxiety reaction" indexes to F41.1 and plain "anxiety" to F41.9. Name the adjustment disorder in the assessment.
- No stressor in the note. The diagnosis rests on it, so a note without one gives a reviewer nothing to check.
- Keeping F43.22 after low mood becomes prominent. Switch to F43.23 and write down what changed.
- Missing a trauma reaction. Anxiety after a traumatic event may be an acute stress reaction (F43.0) or PTSD (F43.1-) rather than an adjustment disorder.
- Billing the header. F43.2 isn't billable. The claim needs the full five-character code.
Checked against the FY2027 ICD‑10‑CM code set from CMS on October 12, 2026. F43.22 did not change this year.