Summary & Overview

HCPCS G6049: Epiandrosterone Laboratory/Administration

HCPCS Level II code G6049 identifies epiandrosterone, a steroid-related laboratory substance used in clinical testing or as a pharmacologic agent. Nationally, accurate classification of such HCPCS Level II codes matters for billing consistency, claims adjudication, and tracking utilization of specialized laboratory substances and injectable or administered agents.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context and site-of-service implications, along with benchmarking expectations and relevant policy considerations affecting coverage and coding practices. The summary outlines what to expect in payer coverage patterns, typical modifiers and billing practice notes where available, and directions for locating further coding details.

This publication serves as a practical reference for revenue cycle, clinical laboratory management, and compliance teams seeking a national-level briefing on HCPCS Level II code G6049 and its role in laboratory and outpatient service lines.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG6049HCPCS Level IIEpiandrosteroneLaboratory ServicesOutpatient AdministrationDrug AssayBilling GuidanceRevenue CycleClinical Laboratory

Billing Code Overview

HCPCS Level II code G6049 represents Epiandrosterone, a steroid-related laboratory substance. The service type is laboratory/drug assay or pharmacologic agent administration derived from the code description. The typical site of service is clinical laboratory or outpatient infusion/administration setting, based on the nature of the substance and common practice for similar HCPCS Level II drug and laboratory codes.

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Clinical & Coding Specifications

Clinical Context

Epiandrosterone (G6049) is a steroid-related compound sometimes ordered as part of specialized laboratory testing panels evaluating adrenal or gonadal steroid metabolism. A typical patient scenario involves an adult patient presenting to an endocrinology clinic with symptoms such as unexplained hirsutism, virilization, irregular menses, or signs of androgen excess and an initial biochemical workup suggests abnormal androgen metabolites. The clinical workflow includes: initial outpatient evaluation by an endocrinologist or specialty clinic; collection of a blood specimen (or urine if the laboratory requires) for steroid panel analysis; specimen processing by the laboratory technical component (TC) where extraction and specific assay (e.g., mass spectrometry) measures epiandrosterone concentration; reporting of results to the ordering provider; and follow-up clinical interpretation and management planning by the endocrinologist or primary care provider.

Coding Specifications

Modifier	Description	When to Use
`TC`	Technical component	Use when billing only the laboratory or facility portion of testing for epiandrosterone (instrumentation, reagents, and technical personnel).
`26`	Professional component	Use when billing only the professional interpretation or consultation associated with the test (if applicable).
`59`	Distinct procedural service	Use when the epiandrosterone test is a distinct service separate from another billed laboratory procedure on the same day.
`91`	Repeat clinical diagnostic laboratory test	Use when the test is repeated on the same day to confirm prior result.
`QW`	CLIA waived test	Use if the specific assay is CLIA-waived (rare for specialized steroid testing).
`24`	Unrelated E/M service by the same physician during postoperative period	Use if an unrelated evaluation is performed at the time of ordering/testing and the provider is in a postoperative global period.
`25`	Significant, separately identifiable E/M service by the same provider on the same day	Use if a distinct E/M visit accompanies the order for the test.
`XE`	Separate encounter, only	Use when the laboratory encounter for the test is distinct from other services on the same day.
`XP`	Separate practitioner, only	Use when a different practitioner performed the technical component separate from the ordering practitioner.
`XS`	Separate structure, only	Use when the service is performed on a separate anatomical site or specimen distinct from other billed tests.

Taxonomy Code	Specialty	Notes
207RE0101X	Endocrinology, Diabetes & Metabolism	Endocrinologists commonly order and interpret steroid panels including epiandrosterone.
207Q00000X	Family Medicine	Primary care clinicians frequently initiate evaluation for androgen excess and order initial laboratory testing.
207RH0000X	Internal Medicine	General internists manage endocrine complaints and coordinate testing.
261QM0800X	Clinical Laboratory	Laboratory directors and clinical pathologists oversee assay performance and reporting.
207K00000X	Obstetrics & Gynecology	Gynecologists evaluate menstrual irregularities and hirsutism and may order androgen testing.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E28.1`	Polycystic ovarian syndrome	Common cause of androgen excess; epiandrosterone may be part of metabolic steroid evaluation.
`E28.2`	Androgen excess	Directly related to measurement of androgen metabolites.
`E24.0`	Pituitary-dependent Cushing disease	Hypercortisolemia can alter steroid metabolism; broad steroid panels may include epiandrosterone.
`N92.6`	Irregular menstruation, unspecified	Menstrual irregularities prompt evaluation for androgen and adrenal causes.
`R68.2`	Excessive hair growth (hirsutism)	Clinical sign of androgen excess leading to measurement of androgen metabolites.
`C79.8`	Secondary malignant neoplasm of other specified sites	Neoplastic sources (adrenal or ovarian) can produce steroid hormones; steroid profiling may be used in evaluation.
`E27.8`	Other specified adrenocortical dysfunction	Adrenal disorders affecting steroidogenesis may warrant epiandrosterone testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80053`	Comprehensive metabolic panel; 14 tests	Frequently ordered alongside steroid testing to assess metabolic status prior to interpretation.
`80061`	Lipid panel	May be included in baseline laboratory evaluation in patients with endocrine disorders.
`83036`	Hemoglobin; glycated (A1c)	Ordered in metabolic assessment for patients with endocrine abnormalities.
`84154`	Testosterone; total	Commonly ordered in the evaluation of androgen excess and to correlate with epiandrosterone levels.
`84403`	Thyroid stimulating hormone (TSH)	Thyroid function testing is often part of an endocrine workup that includes steroid assays.