E0350 Bowel Irrigation Control Unit Reimbursement | OpenPayer

Summary & Overview

HCPCS E0350: Control Unit for Electronic Bowel Irrigation System

HCPCS Level II code E0350 denotes a control unit for an electronic bowel irrigation/evacuation system, a durable medical equipment device used to manage bowel function in patients with neurogenic bowel, severe constipation, or fecal incontinence. Nationally, coverage and utilization of such devices affect home health care, durable medical equipment suppliers, and payers managing long-term care costs for patients with chronic bowel dysfunction.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for use of the device, common billing considerations, and payer coverage patterns where available. The publication summarizes benchmarks for billing and utilization, highlights policy updates relevant to durable medical equipment and home-based bowel management, and outlines coding relationships that may affect claim adjudication.

This summary aims to orient clinicians, DME suppliers, and billing professionals to the primary purpose of E0350, typical sites of service, and the payer landscape nationally. Data not included in the input is noted where applicable. The content provides a concise reference for understanding what the code represents and what topics are addressed in the full publication.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE0350HCPCS Level IIdurable medical equipmentbowel irrigationhome healthdevice control unitDME billingbowel managementmedical device coding

Billing Code Overview

HCPCS Level II code E0350 represents a control unit for an electronic bowel irrigation/evacuation system. This device is part of an assistive technology service that provides mechanical or electronic control to operate bowel irrigation systems designed to manage fecal incontinence or severe constipation.

Service Type: Durable medical equipment (DME) — bowel irrigation control unit

Typical Site of Service: Home health or outpatient/home setting where patients receive long-term bowel management or neurogenic bowel care

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with chronic neurogenic bowel dysfunction (for example, following spinal cord injury or multiple sclerosis) who requires a home electronic bowel irrigation/evacuation system to manage severe constipation and fecal incontinence. The patient has failed conservative measures such as dietary modification, oral laxatives, suppositories, and digital stimulation. A gastroenterology or physiatry clinic visit documents need for a motorized irrigation system; a clinician prescribes a control unit and coordinates DME (durable medical equipment) delivery. The clinical workflow includes evaluation and documentation of diagnosis and functional impairment, trial of conservative therapies, demonstration of device use in clinic or home health setting, prescriptions and DME orders sent to a supplier, and follow-up to assess device efficacy and complications. Typical site of service is outpatient clinic, durable medical equipment supplier, or patient home with home health support.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required to train patient/caregiver or perform extended device configuration markedly exceeds usual time/effort for device provision and documentation supports increased complexity.
`52`

HCPCS E1821: Replacement Soft Interface Cuffs for Static Progressive Stretch Device

HCPCS-E0469-CONTINUOUS-HIGH-FREQUENCY-OSCILLATION-NEBULIZATION-DEVICE

HCPCS Level II E0469: Lung Expansion Airway Clearance Device with Nebulization

HCPCS-E1225-WHEELCHAIR-SEMI-RECLINING-BACK-ACCESSORY

HCPCS E1225: Manual Wheelchair Semi-Reclining Back Accessory

HCPCS-E1240-LIGHTWEIGHT-WHEELCHAIR-DETACHABLE-ARMS-ELEVATING-LEGREST

HCPCS E1240: Lightweight Wheelchair with Detachable Arms and Elevating Legrest

HCPCS-E0447-PORTABLE-LIQUID-OXYGEN-HIGH-FLOW-MONTHLY-SUPPLY

HCPCS E0447: Portable Liquid Oxygen, Monthly Supply for >4 lpm

HCPCS-E2321-POWER-WHEELCHAIR-HAND-CONTROL-REMOTE-JOYSTICK-NONPROPORTIONAL

HCPCS E2321: Power Wheelchair Hand Control Remote Joystick, Nonproportional

HCPCS-E1358-DC-POWER-ADAPTER-PORTABLE-OXYGEN-CONCENTRATOR-REPLACEMENT

HCPCS E1358: DC Power Adapter for Portable Oxygen Concentrator, Replacement Only

HCPCS-E0957-WHEELCHAIR-MEDIAL-THIGH-SUPPORT

HCPCS E0957: Wheelchair Medial Thigh Support

HCPCS-E0791-STATIONARY-PARENTERAL-INFUSION-PUMP

HCPCS E0791: Parenteral Infusion Pump, Stationary, Single or Multi-Channel

HCPCS-E0944-PELVIC-BELT-HARNESS-BOOT

HCPCS E0944: Pelvic Belt/Harness/Boot

Showing 1–10 of 670

Taxonomy Code	Specialty	Notes
2084P0800X	Physical Medicine & Rehabilitation	PM&R physicians manage neurogenic bowel and prescribe DME such as electronic irrigation systems.
207RC0000X	Gastroenterology	Gastroenterologists evaluate refractory constipation and can prescribe and oversee bowel irrigation therapy.
363L00000X	Medical Equipment Supplier	DME suppliers and durable medical equipment providers supply and service the control unit and accessories.
367500000X	Home Health Services	Home health clinicians provide training and support for device use in the home setting.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K59.00`	Constipation, unspecified	Chronic constipation is a primary indication for electronic bowel irrigation to achieve regular evacuation.
`K59.09`	Other constipation	Captures constipation etiologies where irrigation may be used when conservative measures fail.
`K59.3`	Megacolon	Colonic inertia or megacolon may necessitate mechanical irrigation as part of bowel management strategies.
`G83.4`	Cauda equina syndrome	Neurogenic bowel from cauda equina can require electronic irrigation for bowel evacuation.
`G82.50`	Paraplegia, unspecified	Spinal cord injury leading to paraplegia often causes neurogenic bowel dysfunction treated with irrigation systems.
`G35`	Multiple sclerosis	MS-related neurogenic bowel dysfunction may be managed with irrigation systems to reduce incontinence and constipation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`94640`	Airway management; intermittent positive pressure breathing (IPPB) — therapeutic or diagnostic procedures for respiratory therapy	Not directly related; included only if respiratory therapy is required during clinic procedures or transport; otherwise Data not available in the input.
`99406`	Smoking and tobacco use cessation counseling, intermediate, greater than 3 minutes up to 10 minutes	Not directly related; see note below.
`97161`	Physical therapy evaluation, low complexity	Physical or occupational therapy evaluations for bowel management training and ADL support often occur in the same care plan when functional impairment is present.
`97530`	Therapeutic activities, direct (one-on-one) patient, each 15 minutes	Used when therapists provide one-on-one training for use of bowel irrigation systems and caregiver instruction.
`99070`	Supplies and materials (except spectacles), provided by physician over and above those usually included with the office visit	Used if additional supplies for device demonstration or single-use accessories are supplied during clinic encounter.

Note: If specific CPT codes directly tied to device billing (such as implantation procedures) are required, include them in the billing workflow; otherwise common adjacent services include therapy training and DME supply coordination.

OpenPayer