???? 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 billed for the gastroesophageal reflux test. Proper documentation during claim submission is essential for correct reimbursements. Therefore, healthcare organizations often outsource medical billing to streamline the revenue cycle.

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 applies to a gastroesophageal reflux test, more info also known as the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. 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: Used for interpretation and report only


• Modifier TC: Covers the technical component


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


• Modifier 53: Reports halted procedures.


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


• Modifier 76: Shows repeat procedure by same provider


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

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

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

???? Top CPT 91035 Coding Mistakes

1️⃣ Modifier Confusion

If staff use modifier 77 instead of 59 for CPT 91035, the reimbursement can be delayed. Always double-check the CPT pairing before submission.

2️⃣ Poor Claim Documentation

Improperly filled forms can cause reimbursement delays. Ensure clarity in every billing field, including documentation of service level

???? Final Thoughts

Gastroesophageal reflux disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers bill under CPT Code 91035 to ensure correct payment. Correct modifier usage and accurate coding optimize the revenue cycle.