???? A Comprehensive Guide to CPT Code 91035

???? 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, healthcare organizations often delegate billing tasks to streamline financial performance.

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 applies to a gastroesophageal reflux website test, also known as the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Detailed reporting ensures accurate reimbursement.

???? Applicable Modifiers for CPT 91035

Various modifiers are used with CPT 91035 under unique clinical circumstances. Let’s review 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: Applied when treatment stops for patient safety

Modifier 59: Reports separate, non-overlapping procedures.

Modifier 76: Shows repeat procedure by same provider

Modifier 77: Reports repeat service by different provider

⚖️ Relation Between CPT 91035 and 00812?

CPT 91035 and CPT 00812 represent read more unrelated procedures.
CPT 91035 covers gastroesophageal pH monitoring, while CPT 00812 refers to anesthesia during colonoscopy

???? Common Mistakes to Avoid When Billing CPT Code 91035

1️⃣ Using the Wrong Modifier

Incorrect modifier selection for CPT 91035, it could lead to billing rejections. Always review payer-specific rules before submission.

2️⃣ Missing Details in Billing

Missing patient or provider information can lead to claim rejection. Ensure completeness in every billing field, including patient info, procedure details, and modifiers

???? Conclusion

GERD is diagnosed through pH monitoring that measures acid exposure in the esophagus.
Providers bill under CPT Code 91035 to ensure correct payment. Correct modifier usage and accurate coding optimize the revenue cycle.