???? Everything You Should Know About CPT Code 91035

Introduction:

GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 applies to the gastroesophageal reflux test. Proper documentation during claim submission is vital for correct reimbursements. Therefore, healthcare organizations often outsource medical billing to streamline financial performance.

???? Understanding CPT 91035

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 reports a gastroesophageal reflux test, get more info popularly called the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Detailed reporting ensures accurate reimbursement.

???? CPT 91035 Modifier Details

Multiple modifiers are used with CPT 91035 under different clinical circumstances. Let’s go through them:

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


• Modifier TC: Reports the procedural performance aspect.


• Modifier 52: Used when service is partially reduced


• Modifier 53: Used if the procedure is discontinued


• 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 unrelated procedures.
CPT 91035 is used check here for reflux diagnosis, while CPT 00812 refers to anesthesia during colonoscopy

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

1️⃣ Modifier Confusion

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 lead to claim rejection. Ensure clarity in every billing field, including all claim data.

???? Conclusion

GERD is diagnosed through pH monitoring that measures acid exposure in the esophagus.
Providers use CPT 91035 for reimbursement to document GERD diagnosis accurately. Correct modifier usage and accurate coding boost claim acceptance rates.