???? Everything You Should Know About CPT Code 91035

Introduction:

GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 applies to the gastroesophageal reflux test. Proper documentation during claim submission is essential for correct reimbursements. Therefore, providers often partner with billing experts to streamline the revenue cycle.

???? Understanding CPT 91035

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 represents a gastroesophageal reflux test, commonly referred to as the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Detailed reporting ensures accurate reimbursement.

???? Applicable Modifiers for CPT 91035

Various modifiers can accompany CPT 91035 under different clinical circumstances. Let’s go through them:

• Modifier 26: Indicates the physician’s portion of service.


• Modifier TC: Covers the technical component


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


• Modifier 53: Applied when treatment stops for patient safety


• Modifier 59: Reports separate, non-overlapping procedures.


• Modifier 76: Indicates repeated service.


• Modifier 77: Reports repeat service by different provider

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

No, they are not related.
CPT 91035 reports GERD testing, get more info while CPT 00812 refers to anesthesia during colonoscopy

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

1️⃣ Using the Wrong Modifier

When coders choose the wrong modifier for CPT 91035, the reimbursement can be delayed. Always double-check the CPT pairing before submission.

2️⃣ Poor Claim Documentation

Incomplete or incorrect details can lead to claim rejection. Ensure accuracy in every billing field, including patient info, procedure details, and modifiers

???? Key Takeaway

GERD is diagnosed through get more info pH monitoring that measures acid exposure in the esophagus.
Providers bill under CPT Code 91035 to document GERD diagnosis accurately. Correct modifier usage and proper claim preparation enhance financial performance.