???? 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 is used for the gastroesophageal reflux test. Accurate coding during claim submission is critical for correct reimbursements. Therefore, healthcare organizations often outsource medical billing to streamline the revenue cycle.

???? What is CPT Code 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 monitors acid pH via mucosal-attached telemetry electrodes. Comprehensive details assist in justifying claims.

???? Modifiers for CPT Code 91035

Several modifiers are used with CPT 91035 under specific clinical circumstances. Let’s go through them:

• Modifier 26: Bills the professional component


• Modifier TC: Refers to the equipment and technician cost


• Modifier 52: Indicates reduced service.


• Modifier 53: Reports halted procedures.


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


• Modifier 76: Shows repeat procedure by same provider


• Modifier 77: Reports repeat service by different provider

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

No, they more info are not related.
CPT 91035 reports GERD testing, while CPT 00812 is assigned for colonoscopy anesthesia billing.

???? Top CPT 91035 Coding Mistakes

1️⃣ Modifier Confusion

Incorrect modifier selection for CPT 91035, the reimbursement can be delayed. Always double-check the CPT pairing before submission.

2️⃣ Inaccurate 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 click here disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers use CPT 91035 for reimbursement to ensure correct payment. Correct modifier usage and precise billing optimize the revenue cycle.