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

Introduction:

To diagnose GERD effectively, providers perform acid level monitoring with telemetry pH electrode placement.
In medical billing, CPT Code 91035 is used for the gastroesophageal reflux test. Accurate coding during claim submission is critical for correct reimbursements. Therefore, healthcare organizations often partner with billing experts to streamline the revenue cycle.

???? What is CPT Code 91035?

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 reports a gastroesophageal reflux test, popularly called the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Comprehensive details assist in justifying claims.

???? Modifiers for CPT Code 91035

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

• Modifier 26: Bills the professional component


• Modifier TC: Covers the technical component


• Modifier 52: Used when service is partially reduced


• Modifier 53: Used if the procedure is discontinued


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


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


• Modifier 77: Indicates separate provider involvement.

⚖️ Difference Between CPT 91035 and 00812

CPT 91035 and CPT 00812 represent unrelated procedures.
CPT 91035 is used for read more reflux diagnosis, while CPT 00812 represents anesthesia services

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

1️⃣ Incorrect Modifier Usage

If staff use modifier 77 instead of 59 for CPT 91035, claims may be denied. Always review payer-specific rules before submission.

2️⃣ Poor Claim Documentation

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

???? Key Takeaway

Gastroesophageal reflux disease diagnosis involves analyzing more info acid backflow with pH monitoring.
Providers bill under CPT Code 91035 to document GERD diagnosis accurately. Correct modifier usage and accurate coding enhance financial performance.