HCPCS E1592: Automatic Intermittent Peritoneal Dialysis System - OpenPayer

Summary & Overview

HCPCS E1592: Automatic Intermittent Peritoneal Dialysis System

HCPCS Level II code E1592 represents an automatic intermittent peritoneal dialysis system, a form of durable medical equipment used to deliver automated cyclical peritoneal dialysis, primarily in home and outpatient settings. Nationally, this code matters because automated peritoneal dialysis supports home-based renal replacement therapy, influences equipment coverage decisions, and affects durable medical equipment (DME) policy and reimbursement for dialysis providers and suppliers. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will learn the clinical context for automated peritoneal dialysis systems, the typical sites of service, and what to expect from payer coverage patterns. The publication provides benchmarks for common billing and reimbursement considerations, summarizes relevant policy themes affecting DME coverage, and highlights how the HCPCS classification ties to service delivery for patients requiring intermittent peritoneal dialysis. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCignaUnitedHealthcareMedicareE1592HCPCS Level IIperitoneal dialysishome dialysisdurable medical equipmentautomated dialysis systemrenal replacement therapyoutpatient care

Billing Code Overview

HCPCS Level II code E1592 describes an automatic intermittent peritoneal dialysis system. This code covers a mechanical system designed to deliver automated cyclical peritoneal dialysis therapy, typically used for patients requiring renal replacement therapy on a repeated intermittent schedule.

Service type: Durable medical equipment for dialysis delivery, specifically an automated peritoneal dialysis system
Typical site of service: Home dialysis setting or other outpatient/residential settings where home-based automated peritoneal dialysis is administered

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with end-stage renal disease (ESRD) on home peritoneal dialysis is evaluated for recurrent ultrafiltration failure and inadequate clearance using manual exchanges. The nephrology team elects to initiate an E1592 Automatic intermittent peritoneal dialysis system to provide scheduled automated nocturnal exchanges. The workflow includes: outpatient nephrology assessment, peritoneal access evaluation (existing peritoneal dialysis catheter), patient and caregiver training on device operation and troubleshooting, prescription of dialysate volumes and exchange schedule, baseline laboratory studies (serum chemistries, dialysate cell count if indicated), home setup by durable medical equipment (DME) vendor, initial in-home visit to verify connections and alarms, periodic remote monitoring or clinic follow-up for adequacy, and device servicing or replacement as clinically indicated. Typical site of service is the patient’s home; device setup and training may occur in an outpatient dialysis or nephrology clinic prior to discharge home.

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced services	Use when the device/system is provided with reduced functionality or fewer prescribed exchanges than typical.

HCPCS E2629: Wheelchair Mobile Arm Support, Balanced Friction Dampening

HCPCS-E1172-AMPUTEE-WHEELCHAIR-DETACHABLE-ARMS-NO-FOOTRESTS

HCPCS Level II E1172: Amputee Wheelchair with Detachable Arms

HCPCS-E0157-CRUTCH-ATTACHMENT-WALKER

HCPCS E0157: Crutch Attachment for Walker, Each

HCPCS-E2387-POWER-WHEELCHAIR-FOAM-FILLED-CASTER-TIRE-REPLACEMENT

HCPCS Level II E2387: Power Wheelchair Foam-Filled Caster Tire, Replacement Only

HCPCS-E2627-WHEELCHAIR-SHOULDER-ELBOW-MOBILE-ARM-SUPPORT

HCPCS E2627: Wheelchair Shoulder/Elbow Mobile Arm Support

HCPCS-E1002-POWER-SEATING-TILT-ONLY-WHEELCHAIR-ACCESSORY

HCPCS E1002: Wheelchair Accessory, Power Seating System, Tilt Only

HCPCS-E0920-FRACTURE-FRAME-BED-TRACTION-DEVICE

HCPCS E0920: Fracture Frame Attached to Bed, Includes Weights

HCPCS-E2610-POWERED-WHEELCHAIR-SEAT-CUSHION

HCPCS E2610: Wheelchair Seat Cushion, Powered

HCPCS-E1570-ADJUSTABLE-DIALYSIS-CHAIR-ESRD

HCPCS E1570: Adjustable Chair for ESRD Patients

HCPCS-E2630-MOBILE-ARM-SUPPORT-SHOULDER-ELBOW-HAND-SLING

HCPCS Level II E2630: Wheelchair Mobile Arm Support, Shoulder-Elbow-Hand

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Taxonomy Code	Specialty	Notes
`2080P0800X`	Nephrology	Physicians who manage dialysis prescriptions and ongoing patient monitoring.
`363LP0800X`	Dialysis Facility	Facilities that provide peritoneal dialysis training and oversight; relevant for setup/training visits.
`103T00000X`	Physician Assistant	Clinicians who may perform training, patient education, and supervised device management.
`163W00000X`	Nurse Practitioner	Advanced practice providers involved in initiation, follow-up, and remote monitoring of therapy.
`261QM0800X`	Home Health Agency	Agencies that coordinate home delivery, setup, and durable medical equipment services.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N18.6`	End stage renal disease	Primary indication for chronic peritoneal dialysis and use of an automated system.
`N18.5`	Chronic kidney disease, stage 5	Clinical stage preceding ESRD where dialysis initiation and automated systems are considered.
`R65.1`	Systemic inflammatory response syndrome (SIRS) of infectious origin	Relevant as a potential complication (peritonitis) that may interrupt automated PD therapy.
`K65.9`	Peritonitis, unspecified	Direct complication of peritoneal dialysis requiring evaluation and possible discontinuation of automated therapy.
`T82.7XXA`	Infection and inflammatory reaction due to other cardiac and vascular device, implant and graft, initial encounter	Included as an example of device-related infection coding patterns; device-specific codes for PD catheter infection are used clinically.
`Z99.2`	Dependence on renal dialysis	Indicates ongoing dependence on dialysis technology, supporting medical necessity for automated systems.
`E87.1`	Hypo-osmolality and hyponatremia	Metabolic disturbances that may be monitored and managed during dialysis therapy.
`E86.0`	Dehydration	Potential clinical issue related to ultrafiltration and dialysis prescriptions that automated cyclers manage.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49422`	Peritoneal dialysis catheter placement, initial insertion, open, Seldinger, or percutaneous techniques	Peritoneal access placement that precedes use of an automated peritoneal dialysis system when a new catheter is required.
`49900`	Removal of peritoneal dialysis catheter	Performed when catheter removal is necessary prior to device discontinuation or replacement.
`90945`	Dialysis procedures other than in-center hemodialysis; training for home dialysis per week, for a patient and caregiver	Billed for initial training in peritoneal dialysis techniques, including device operation and exchange procedures.
`90947`	Hemodialysis procedure with single evaluation by physician	While focused on hemodialysis, included here for completeness when coordinating dialysis modalities; less directly related but relevant in modality transitions.
`90999`	Unlisted dialysis procedure or service	Used for procedures or services related to automated peritoneal dialysis not otherwise specified in CPT coding.

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