Anxiety disorder due to another medical condition. If the panic or anxiety symptoms are attributed to the physiological consequences of another medical condition (i.e., rather than to the medication taken for the medical condition), anxiety disorder due to another medical condition should be diagnosed. The history often provides the basis for such a judgment. At times, a change in the treatment for the other medical condition (e.g., med- ication substitution or discontinuation) may be needed to determine whether the medica- tion is the causative agent (in which case the symptoms may be better explained by substance/medication-induced anxiety disorder). If the disturbance is attributable to both another medical condition and substance use, both diagnoses (i.e., anxiety disorder due to given. When there is insufficient evidence to determine whether the panic or anxiety symp- toms are attributable to a substance/medication or to another medical condition or are pri- mary (i.e., not attributable to either a substance or another medical condition), a diagnosis of other specified or unspecified anxiety disorder would be indicated.
Diagnostic Criteria 293.84 (F06.4)
A. Panic attacks or anxiety is predominant in the clinical picture.
B. There is evidence from the history, physical examination, or laboratory findings that the dis- turbance is the direct pathophysiological consequence of another medical condition.
C. The disturbance is not better explained by another mental disorder.
D. The disturbance does not occur exclusively during the course of a delirium.
E. The disturbance causes clinically significant distress or impairment in social. occupa- tional, or other important areas of functioning.
Coding note: Include the name of the other medical condition within the name of the men- tal disorder (e.g.. 293.84 [F06.4] anxiety disorder due to pheochromocytoma). The other medical condition should be coded and listed separately immediately before the anxiety disorder due to the medical condition (e.g., 227.0 [D3500] pheochromocytoma; 293.84 [F06.4] anxiety disorder due to pheochromocytoma.
The essential feature of anxiety disorder due to another medical condition is clinically signifi- cant anxiety that is judged to be best explained as a physiological effect of another medical con- dition. Symptoms can include prominent anxiety symptoms or panic attacks (Criterion A).
The judgment that the symptoms are best explained by the associated physical condition must be based on evidence from the history, physical examination, or laboratory findings (Criterion
B). Additionally, it must be judged that the symptoms are not better accounted for by another mental disorder, in particular, adjustment disorder, with anxiety, in which the stressor is the medical condition (Criterion C). In this case, an individual with adjustment disorder is espe- cially distressed about the meaning or the consequences of the associated medical condition.
By contrast, there is often a prominent physical component to the anxiety (e.g., shortness of breath) when the anxiety is due to another medical condition. The diagnosis is not made if the anxiety symptoms occur only during the course of a delirium (Criterion D). The anxiety symp- toms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion E).
In determining whether the anxiety symptoms are attributable to another medical con- dition, the clinician must first establish the presence of the medical condition. Further- more, it must be established that anxiety symptoms can be etiologically related to the is the best explanation for the symptoms in a specific individual. A careful and compre-