???? A Comprehensive Guide to CPT Code 91035

???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

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

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 applies to a gastroesophageal reflux test, popularly called the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Proper documentation supports payer understanding.

???? Modifiers for CPT Code 91035

Various modifiers are used with CPT 91035 under different clinical circumstances. Let’s break down them:

Modifier 26: Used for interpretation and report only

Modifier TC: Covers the technical component

Modifier 52: Used when service is partially reduced

Modifier 53: Used if the procedure is discontinued

Modifier 59: Indicates a distinct procedure performed the same day

Modifier 76: Applied when test is repeated on same day

Modifier 77: Reports repeat service by different provider

⚖️ Difference Between CPT 91035 and 00812

CPT 91035 and CPT 00812 check here represent unrelated procedures.
CPT 91035 is used for reflux diagnosis, while CPT 00812 refers to anesthesia during colonoscopy

???? Top CPT 91035 Coding Mistakes

1️⃣ Using the Wrong Modifier

Incorrect modifier selection for CPT 91035, the reimbursement can be delayed. Always review payer-specific rules before submission.

2️⃣ Inaccurate Documentation

Missing patient or provider information can lead to claim rejection. Ensure completeness in every billing field, including patient info, procedure details, and modifiers

???? Key Takeaway

To detect reflux here disease, doctors perform pH testing using telemetry electrodes.
Providers bill under CPT Code 91035 to receive appropriate reimbursement. Correct modifier usage and proper claim preparation optimize the revenue cycle.