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TRICARE Policy Manual 6010.60-M, April 1, 2015
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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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