???? A Comprehensive Guide to CPT Code 91035

Introduction:

The gastroesophageal reflux test monitors acid abnormalities in the stomach.
In medical billing, CPT Code 91035 is billed for the gastroesophageal reflux test. Accurate coding during claim submission is critical 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 reports a gastroesophageal website reflux test, popularly called the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Detailed reporting ensures accurate reimbursement.

???? Modifiers for CPT Code 91035

Multiple modifiers are used with CPT 91035 under unique clinical circumstances. Let’s break down them:

• Modifier 26: Bills the professional component


• Modifier TC: Reports the procedural performance aspect.


• Modifier 52: Indicates reduced service.


• Modifier 53: Used if the procedure is discontinued


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


• Modifier 76: Applied when test is repeated on same day


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

⚖️ Difference 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, claims may be denied. Always verify the correct modifier before submission.

2️⃣ Inaccurate Documentation

Incomplete or incorrect details can lead to claim rejection. Ensure completeness in every billing field, including all claim data.

???? Key Takeaway

Gastroesophageal reflux disease diagnosis involves analyzing acid backflow website with pH monitoring.
Providers submit CPT 91035 to insurers to document GERD diagnosis accurately. Correct modifier usage and precise billing boost claim acceptance rates.