Summary & Overview
HCPCS G6024: Colonoscopy Proximal to Splenic Flexure with Lesion Ablation
HCPCS Level II code G6024 denotes a flexible colonoscopy performed proximal to the splenic flexure with ablation of tumors, polyps, or other lesions not removable by hot biopsy forceps, bipolar cautery, or snare technique. This code captures a specific therapeutic endoscopic service used when lesions require ablation rather than excision, and it is clinically important for colorectal cancer prevention and management as well as symptom control.
Key national payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage and reimbursement policies for this procedure affect access to advanced endoscopic therapies across outpatient surgical and hospital outpatient settings.
Readers will find benchmarks for utilization and payment (where available), relevant policy and coverage considerations, and the clinical context that differentiates ablation-focused colonoscopic services from polypectomy or excisional techniques. The summary also outlines typical sites of service and the procedural elements that define when G6024 is the appropriate administrative code. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code G6024 describes a flexible colonoscopy performed proximal to the splenic flexure with ablation of tumor(s), polyp(s), or other lesion(s) that are not amenable to removal by hot biopsy forceps, bipolar cautery, or snare technique. The procedure involves endoscopic visualization of the proximal colon and targeted tissue ablation as the primary therapeutic action.
Service type: Endoscopic colorectal therapeutic procedure involving lesion ablation.
Typical site of service: Ambulatory surgical center or hospital outpatient department for endoscopic colorectal intervention.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of iron-deficiency anemia and prior incomplete polypectomy is scheduled for a diagnostic and therapeutic colonoscopy. During colonoscopic navigation to the proximal colon (beyond the splenic flexure), the endoscopist identifies multiple sessile and flat lesions that are not amenable to removal with hot biopsy forceps, bipolar cautery, or standard snare techniques due to size, morphology, or location. The procedure performed is a flexible colonoscopy with endoscopic ablation of tumor(s), polyp(s), or other lesion(s) in the proximal colon using advanced ablation modalities (for example, argon plasma coagulation or other ablative energy delivery) to eradicate residual lesion tissue.
The clinical workflow includes pre-procedure evaluation and informed consent, bowel preparation verification, moderate sedation or monitored anesthesia care per facility policy, endoscopic inspection to the cecum, lesion assessment and documentation (size, morphology, location proximal to the splenic flexure), performance of ablative therapy when endoscopic resection is not feasible or safe, retrieval or biopsy when possible for histology, post-procedure recovery, and instructions for follow-up surveillance and pathology review.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when a distinct E/M is performed on the same date as the colonoscopy and must be billed separately. |