???? A Comprehensive Guide to 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 used for the gastroesophageal reflux test. Coding precision during claim submission is vital for correct reimbursements. Therefore, providers 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 here as the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Proper documentation supports payer understanding.

???? CPT 91035 Modifier Details

Several modifiers can accompany CPT 91035 under specific clinical circumstances. Let’s review 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: Indicates a distinct procedure performed the same day


• Modifier 76: Indicates repeated service.


• Modifier 77: Used when another physician performs the same test

⚖️ Difference Between CPT 91035 and 00812

These codes refer to different services.
CPT 91035 covers gastroesophageal check here pH monitoring, while CPT 00812 represents anesthesia services

???? Billing Errors to Watch Out for in CPT 91035

1️⃣ Incorrect Modifier Usage

When coders choose the wrong modifier for CPT 91035, claims may be denied. Always double-check the CPT pairing before submission.

2️⃣ Missing Details in Billing

Incomplete or incorrect details can cause reimbursement delays. Ensure completeness in every billing field, including patient info, procedure details, and modifiers

???? Conclusion

Gastroesophageal reflux disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers use CPT 91035 for reimbursement to receive appropriate reimbursement. Correct modifier usage and proper claim preparation enhance financial performance.