Other Services
Chapter 8
Section 2.7
Pulsed Irrigation Evacuation
(PIE)
Issue Date: July 3, 2007
Copyright: CPT
only © 2006 American Medical Association (or such other date of
publication of CPT).
All Rights Reserved.
Revision:
1.0 CPT
PROCEDURE CODES
91123, 99511
2.0 HCPCS
CODES
E0350, E0352
3.0 DESCRIPTION
PIE is an automated enema in which small pulses
of warm tap water are delivered into the rectum, serving to rehydrate
feces and promote peristalsis. The system consists of a speculum,
tubing, a disposable collection container, and an electrical unit
that delivers positive and negative air pressure through the tubing.
4.0 POLICY
PIE may be covered for the treatment of patients
with neurogenic bowel who have failed conservative therapy with
bowel retraining (e.g., suppositories, digital stimulation, abdominal massage,
enemas).
5.0 EXCLUSIONS
PIE is excluded when any of the following contraindications
exist:
5.1 Abdominal surgeries in the past 12 months.
5.2 Renal insufficiency.
5.3 Acute diverticulitis.
5.4 Impactions
not in the colon, i.e., ileus.
5.5 Integrity of the colon is
suspect (suspected perforation).
6.0 EFFECTIVE
DATE
January 1, 1997.
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