???? 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 billed for the gastroesophageal reflux test. Accurate coding during claim submission is vital for correct reimbursements. Therefore, healthcare organizations often outsource medical billing to streamline financial performance.

???? What is CPT Code 91035?

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 applies to a gastroesophageal reflux test, popularly called the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Detailed reporting ensures accurate reimbursement.

???? Modifiers for CPT Code 91035

Various modifiers may be appended to CPT 91035 under unique clinical circumstances. Let’s review them:

• Modifier 26: Indicates the physician’s portion of service.


• Modifier TC: Refers to the equipment and technician cost


• Modifier 52: Used when service is partially reduced


• Modifier 53: Applied when treatment stops for patient safety


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


• Modifier 76: Applied when test is repeated on same day


• Modifier 77: Indicates separate provider involvement.

⚖️ Relation Between CPT 91035 and 00812?

No, they read more are not related.
CPT 91035 is used for reflux diagnosis, while CPT 00812 represents anesthesia services

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

Improperly filled forms can result in denied payments. Ensure accuracy in every billing field, including patient info, procedure details, and modifiers

???? Final Thoughts

To detect reflux disease, doctors perform pH testing using get more info telemetry electrodes.
Providers submit CPT 91035 to insurers to receive appropriate reimbursement. Correct modifier usage and precise billing boost claim acceptance rates.