Encopresis not due to a substance or known physiol condition

This code represents the involuntary passage of feces into inappropriate places, such as clothing, in a child who is at least four years old (or has reached a developmental age of four years). It specifically applies when the encopresis is determined to be psychological in origin, rather than caused by a physical condition or substance use.

Use this code when documentation clearly indicates encopresis without an underlying physiological or organic cause. This diagnosis is typically made after medical evaluation has ruled out conditions like Hirschsprung's disease, spinal cord abnormalities, or severe constipation with overflow incontinence. Supporting documentation should reflect a psychological assessment or a diagnosis of functional encopresis.

• Do not code with R15.- (encopresis NOS) as per Excludes1 note; choose the most specific code available.
• Ensure the patient's age or developmental age is at least four years for this diagnosis.
• Look for documentation explicitly stating "functional encopresis" or "psychogenic encopresis" to support this code.