???? 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 applies to the gastroesophageal reflux test. Proper documentation during claim submission is essential for correct reimbursements. Therefore, providers often partner with billing experts 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 as the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Detailed reporting ensures accurate reimbursement.

???? Applicable Modifiers for CPT 91035

Various modifiers can accompany CPT 91035 under different clinical circumstances. Let’s review them:

• Modifier 26: Used for interpretation and report only


• Modifier TC: Covers the technical component


• Modifier 52: Used when service is partially reduced


• Modifier 53: Applied when treatment stops for patient safety


• Modifier 59: Used to prevent bundling errors


• Modifier 76: Indicates repeated service.


• Modifier 77: Indicates separate provider involvement.

⚖️ Difference Between CPT 91035 and 00812

No, they website are not related.
CPT 91035 reports GERD testing, website while CPT 00812 refers to anesthesia during colonoscopy

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

1️⃣ Incorrect Modifier Usage

If staff use modifier 77 instead of 59 for CPT 91035, claims may be denied. 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

???? Key Takeaway

GERD is diagnosed through pH monitoring that measures acid exposure in the esophagus.
Providers submit CPT 91035 to insurers to document GERD diagnosis accurately. Correct modifier usage and proper claim preparation boost claim acceptance rates.