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

???? 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 used for the gastroesophageal reflux test. Proper documentation during claim submission is vital for correct reimbursements. Therefore, healthcare organizations often delegate billing tasks to streamline cash flow.

???? Understanding CPT 91035

The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 applies to a gastroesophageal reflux test, commonly referred to as the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Proper documentation supports payer understanding.

???? Modifiers for CPT Code 91035

Multiple modifiers may be appended to CPT 91035 under different clinical circumstances. Let’s go through them:

Modifier 26: Used for interpretation and report only

Modifier TC: Reports the procedural performance aspect.

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: Shows repeat procedure by same provider

Modifier 77: Used when another physician performs the same test

⚖️ Difference Between CPT 91035 and 00812

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

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

1️⃣ Incorrect Modifier Usage

If staff use modifier 77 instead of 59 for CPT 91035, it could lead to billing rejections. Always double-check the CPT pairing 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

GERD is diagnosed through pH monitoring that measures acid exposure in click here the esophagus.
Providers submit CPT 91035 to insurers to receive appropriate reimbursement. Correct modifier usage and proper claim preparation boost claim acceptance rates.