???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

To diagnose GERD effectively, providers perform acid level monitoring with telemetry pH electrode placement.
In medical billing, CPT Code 91035 applies to the gastroesophageal reflux test. Accurate coding during claim submission is vital for correct reimbursements. Therefore, providers often outsource medical billing to streamline financial performance.

???? What is CPT Code 91035?

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 applies to a gastroesophageal reflux test, read more commonly referred to as the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Proper documentation supports payer understanding.

???? Applicable Modifiers for CPT 91035

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

• Modifier 26: Used for interpretation and report only


• Modifier TC: Refers to the equipment and technician cost


• Modifier 52: Used when service is partially reduced


• Modifier 53: Reports halted procedures.


• Modifier 59: Indicates a distinct procedure performed the same day


• Modifier 76: Indicates repeated service.


• Modifier 77: Reports repeat service by different provider

⚖️ Relation Between CPT 91035 and 00812?

No, they are not related.
CPT 91035 is used for reflux diagnosis, while CPT 00812 is assigned for colonoscopy anesthesia billing.

???? Common Mistakes to Avoid When Billing CPT Code 91035

1️⃣ Using the Wrong Modifier

Incorrect modifier selection for CPT 91035, claims may be denied. Always verify the correct modifier before submission.

2️⃣ Inaccurate Documentation

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

???? Final Thoughts

Gastroesophageal click here reflux disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers submit CPT 91035 to insurers to document GERD diagnosis accurately. Correct modifier usage and proper claim preparation enhance financial performance.