???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 is used for the gastroesophageal reflux test. Accurate coding during claim submission is essential for correct reimbursements. Therefore, healthcare organizations often partner with billing experts to streamline cash flow.

???? Understanding CPT 91035

The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 represents a gastroesophageal reflux test, also known as the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Proper documentation supports payer understanding.

???? Modifiers for CPT Code 91035

Multiple modifiers can accompany CPT 91035 under different clinical circumstances. Let’s go through them:

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


• 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: Applied when test is repeated on same day


• Modifier 77: Indicates separate provider involvement.

⚖️ Difference Between CPT 91035 and 00812

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

???? Top CPT 91035 Coding Mistakes

1️⃣ Modifier Confusion

Incorrect modifier selection for CPT 91035, it could lead to billing rejections. Always verify the correct modifier before submission.

2️⃣ Inaccurate Documentation

Incomplete or incorrect details can lead to claim rejection. Ensure accuracy in every billing field, including patient info, procedure details, and modifiers

???? Conclusion

To detect reflux disease, doctors perform pH website testing using telemetry electrodes.
Providers use CPT 91035 for reimbursement to receive appropriate reimbursement. Correct modifier usage and precise billing boost claim acceptance rates.