???? 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 billed for the gastroesophageal reflux test. Accurate coding during claim submission is essential for correct reimbursements. Therefore, providers often delegate billing tasks to streamline financial performance.

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) establishes guidelines for billing accuracy. more info CPT 91035 represents a gastroesophageal reflux test, popularly called 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 may be appended to CPT 91035 under unique clinical circumstances. Let’s break down 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: Used if the procedure is discontinued


• Modifier 59: Used to prevent bundling errors


• 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?

These codes refer to different services.
CPT 91035 is used for reflux diagnosis, website while CPT 00812 refers to anesthesia during colonoscopy

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

1️⃣ Using the Wrong Modifier

When coders choose the wrong modifier for CPT 91035, the reimbursement can be delayed. Always verify the correct modifier before submission.

2️⃣ Inaccurate Documentation

Improperly filled forms can lead to claim rejection. Ensure clarity in every billing field, including all claim data.

???? Conclusion

Gastroesophageal reflux 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 enhance financial performance.