Understanding encopresis, also known as functional fecal incontinence, is crucial for accurate clinical documentation and medical coding. This resource provides information on encopresis diagnosis, non-retentive encopresis, and related healthcare considerations for medical professionals. Learn about the causes, symptoms, and treatment of encopresis to improve patient care and ensure proper coding for reimbursement.
Also known as
Nonorganic encopresis
Repeated passage of feces into inappropriate places.
Other abdominal pain
May accompany encopresis due to constipation or distension.
Constipation
A common cause and contributing factor to encopresis.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the encopresis with constipation and overflow incontinence?
Yes
Code F98.1 (Encopresis, with constipation and overflow incontinence)
No
Is the encopresis without constipation and overflow incontinence?
When to use each related code
| Description |
|---|
| Repeated passage of stool in inappropriate places. |
| Constipation with overflow incontinence. |
| Functional bowel disorder causing fecal incontinence. |
Encopresis coding requires specifying if it's primary or secondary, impacting medical necessity for certain interventions based on age. Common pediatric diagnosis.
Underlying constipation, Hirschsprung's disease, or psychological issues must be documented. Incomplete documentation affects accurate code assignment and reimbursement.
Differentiating between retentive and non-retentive encopresis is crucial for proper code selection, impacting treatment plans and CDI queries.
Q: What are the most effective evidence-based treatment options for encopresis in children, differentiating between retentive and non-retentive encopresis?
A: Treatment for encopresis depends on whether it's retentive (with constipation) or non-retentive (without). For retentive encopresis, the first step is disimpaction, usually with oral osmotics like polyethylene glycol or, less commonly, rectal enemas. This clears the existing fecal mass. Maintenance therapy then involves consistent use of laxatives to prevent recurrence, combined with behavioral interventions like scheduled toileting and positive reinforcement. Non-retentive encopresis management focuses primarily on behavioral strategies such as regular toilet sits, dietary changes including increased fiber and fluids, and addressing any underlying psychological factors. Explore how a multidisciplinary approach, involving gastroenterologists, psychologists, and dietitians, can improve outcomes in complex cases. Consider implementing standardized bowel management protocols to ensure consistency of care.
Q: How can I differentiate between encopresis and other elimination disorders, like functional constipation or Hirschsprung's disease, during a pediatric evaluation?
A: Distinguishing encopresis from other elimination disorders requires a thorough history, physical exam, and sometimes further investigations. Encopresis, characterized by the repeated passage of stool in inappropriate places, often coexists with functional constipation, where infrequent, hard stools are observed. Hirschsprung's disease, a congenital condition affecting the colon's nerve cells, can present with similar symptoms, but typically appears earlier in infancy with severe constipation and abdominal distention. Red flags suggesting Hirschsprung's include delayed passage of meconium, failure to thrive, and explosive bowel movements after rectal examination. A digital rectal exam is crucial, as it can reveal impacted stool in encopresis or an empty rectum in Hirschsprung's. Abdominal X-rays can assess stool burden and rule out other anatomical abnormalities. In uncertain cases, a rectal biopsy may be needed to confirm Hirschsprung's. Learn more about the diagnostic criteria for elimination disorders to enhance your diagnostic accuracy.
Patient presents with encopresis, also known as functional fecal incontinence, characterized by repeated passage of stool in inappropriate places, such as clothing or the floor. The patient meets the DSM-5 diagnostic criteria for encopresis, including at least one event per month for at least three months, chronological age of at least four years, and the soiling not attributable to the physiological effects of a substance (e.g., laxatives) or another medical condition (e.g., Hirschsprung's disease). Differential diagnosis considered chronic constipation, irritable bowel syndrome, and oppositional defiant disorder. Assessment includes a thorough history of bowel habits, dietary intake, toilet training history, psychosocial stressors, and physical examination including abdominal palpation and rectal examination if clinically indicated. Initial treatment plan focuses on bowel management, including disimpaction if necessary, followed by a maintenance regimen with laxatives such as polyethylene glycol or mineral oil, along with dietary fiber increase and fluids. Behavioral interventions such as scheduled toileting and positive reinforcement will be implemented. Patient education regarding bowel retraining and appropriate toileting habits provided. Follow-up scheduled to monitor treatment effectiveness, adjust medication if needed, and address any ongoing concerns related to fecal incontinence and soiling. ICD-10 code F98.1 assigned for nonretentive encopresis. Future diagnostic considerations may include anorectal manometry or colonic transit study if initial treatment fails.