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

Introduction:

The gastroesophageal reflux test monitors acid abnormalities in the stomach.
In medical billing, CPT Code 91035 is billed for the gastroesophageal reflux test. Proper documentation during claim submission is essential for correct reimbursements. Therefore, clinics often outsource medical billing to streamline financial performance.

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 applies to a gastroesophageal reflux test, also more info known 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 unique clinical circumstances. Let’s break down 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: Indicates repeated service.


• Modifier 77: Reports repeat service by different provider

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

No, they are not related.
CPT 91035 reports check here GERD testing, 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, claims may be denied. Always verify the correct modifier before submission.

2️⃣ Missing Details in Billing

Missing patient or provider information can cause reimbursement delays. Ensure accuracy in every billing field, including patient info, procedure details, and modifiers

???? Key Takeaway

GERD is diagnosed through pH monitoring that measures acid exposure in the esophagus.
Providers submit CPT 91035 to insurers to document GERD diagnosis accurately. Correct modifier usage and precise billing optimize the revenue cycle.