???? 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. Coding precision during claim submission is vital for correct reimbursements. Therefore, clinics often partner with billing experts to streamline the revenue cycle.

???? Understanding CPT 91035

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 applies to a gastroesophageal reflux test, also known more info as the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Detailed reporting ensures accurate reimbursement.

???? Modifiers for CPT Code 91035

Several modifiers may be appended to CPT 91035 under unique clinical circumstances. Let’s break down them:

• Modifier 26: Bills the professional component


• Modifier TC: Covers the technical component


• Modifier 52: Applied when part of the procedure is omitted


• Modifier 53: Used if the procedure is discontinued


• Modifier 59: Indicates a distinct procedure performed the same day


• Modifier 76: Indicates repeated service.


• Modifier 77: Indicates separate provider involvement.

⚖️ Difference Between CPT 91035 and 00812

CPT 91035 and CPT 00812 represent unrelated procedures.
CPT 91035 reports GERD testing, while CPT 00812 refers to anesthesia during colonoscopy

???? 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 accuracy in every billing field, including patient info, procedure details, and modifiers

???? Key Takeaway

Gastroesophageal reflux website disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers use CPT 91035 for reimbursement to ensure correct payment. Correct modifier usage and accurate coding boost claim acceptance rates.