???? 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 outsource medical billing to streamline cash flow.

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 applies to a website gastroesophageal reflux test, 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 can accompany CPT 91035 under different clinical circumstances. Let’s go through them:

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


• Modifier TC: Covers the technical component


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


• Modifier 53: Reports halted procedures.


• Modifier 59: Reports separate, non-overlapping procedures.


• Modifier 76: Shows repeat procedure by same provider


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

⚖️ Relation Between CPT 91035 and 00812?

CPT 91035 and CPT 00812 represent unrelated procedures.
CPT 91035 covers gastroesophageal pH monitoring, while CPT 00812 is assigned for colonoscopy anesthesia billing.

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

1️⃣ Incorrect Modifier Usage

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

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