???? A Comprehensive Guide to CPT Code 91035

Introduction:

GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 is billed for the gastroesophageal reflux test. Accurate coding during claim submission is vital for correct reimbursements. Therefore, clinics often delegate billing tasks to streamline the revenue cycle.

???? What is CPT Code 91035?

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 applies to a gastroesophageal reflux test, more info popularly called the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Detailed reporting ensures accurate reimbursement.

???? Modifiers for CPT Code 91035

Several modifiers may be appended to CPT 91035 under different clinical circumstances. Let’s break down them:

• Modifier 26: Bills the professional component


• Modifier TC: Refers to the equipment and technician cost


• Modifier 52: Applied when part of the procedure is omitted


• Modifier 53: Applied when treatment stops for patient safety


• Modifier 59: Used to prevent bundling errors


• Modifier 76: Applied when test is repeated on same day


• Modifier 77: Used when another physician performs the same test

⚖️ Relation Between CPT 91035 and 00812?

These codes refer to different services.
CPT 91035 get more info is used for reflux diagnosis, while CPT 00812 refers to anesthesia during colonoscopy

???? Billing Errors to Watch Out for in CPT 91035

1️⃣ Modifier Confusion

When coders choose the wrong modifier for CPT 91035, claims may be denied. Always double-check the CPT pairing before submission.

2️⃣ Poor Claim Documentation

Incomplete or incorrect details can result in denied payments. Ensure accuracy in every billing field, including patient info, procedure details, and modifiers

???? Key Takeaway

GERD is diagnosed through pH monitoring that measures acid exposure in the esophagus.
Providers submit CPT 91035 to insurers to ensure correct payment. Correct modifier usage and proper claim preparation optimize the revenue cycle.