Bowel Management Devices

Aetna covers manual pump enema systems (e.g., Peristeen) and related supplies (HCPCS A4453, A4458) for chronic neurogenic bowel only after failure of conservative measures (diet, bowel habit training, laxatives/constipating meds), and also covers gravity-administered enema systems and colorectal stents for palliation or as a bridge to surgery per selection criteria. Aetna considers ingestible vibrating capsules, manual pump systems for idiopathic constipation or fecal incontinence, pulsed irrigation/evacuation systems (e.g., PIE), and rectal inserts experimental/investigational and not covered (PIE also excluded as institutional equipment under Medicare).

"No coverage/frequency limits or age restrictions are specified in the CPB beyond the disease-specific and device-specific exclusions above."

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