Date amended:
External
Statements of Principles
Current RMA Instruments
Reasonable Hypothesis SOP
55 of 2018
Balance of Probabilities SOP
56 of 2018
Changes from previous Instruments
Document
ICD Coding
  • ICD-9-CM Codes:300.01, 300.21
  • ICD-10-AM Codes: F40.01, F41.0
Brief description

This SOP covers recurrent unexpected panic attacks (an abrupt surge of intense fear or discomfort).  Panic attacks with a cue or trigger are not covered by this SOP or this disorder.

Confirming the diagnosis

A report from a specialist psychiatrist that conforms with the Repatriation Commission Guidelines for Psychiatric Compensation Claims is required for diagnosis.

Additional diagnoses covered by SOP
  • Nil
Conditions not covered by SOP:
  • Agoraphobia#
  • Panic attack - not a mental disorder by itself.
  • Panic attacks due to medication/substance use*  - Anxiety disorder SOP
  • Panic attacks due to another medical condition*  - Anxiety disorder SOP
  • Panic attacks occurring in the context of other mental disorders* (e.g.  PTSD, depression, substance use disorder) - part of that disorder

* Another SOP applies

# non-SOP condition 

Clinical onset

Recurrent, unexpected panic attacks, meeting the diagnostic criteria, are required to confirm the diagnosis.  Once the diagnosis has been confirmed, clinical onset can be backdated to the first such episode.  However, an isolated panic attack or a panic attack with a trigger (including due to a substance or another medical condition) will not signify the clinical onset of panic disorder.

Clinical worsening

Clinical worsening may be evidenced by an increase in the frequency or severity of attacks.