???? Everything You Should Know About CPT Code 91035
???? 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 used for the gastroesophageal reflux test. Coding precision during claim submission is essential for correct reimbursements. Therefore, healthcare organizations often delegate billing tasks to streamline cash flow.
???? Understanding CPT 91035
The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 represents a gastroesophageal reflux test, commonly referred to here as the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Detailed reporting ensures accurate reimbursement.
???? Applicable Modifiers for CPT 91035
Multiple modifiers may be appended to CPT 91035 under different clinical circumstances. Let’s review them:
- Modifier 26: Indicates the physician’s portion of service.
- Modifier TC: Refers to the equipment and technician cost
- Modifier 52: Indicates reduced service.
- Modifier 53: Reports halted procedures.
- Modifier 59: Indicates a distinct procedure performed the same day
- Modifier 76: Indicates repeated service.
- Modifier 77: Used when another physician performs the same test
⚖️ Difference Between CPT 91035 and 00812
These codes refer to different services.
CPT 91035 is used for reflux here diagnosis, while CPT 00812 refers to anesthesia during colonoscopy
???? Billing Errors to Watch Out for in CPT 91035
1️⃣ Incorrect Modifier Usage
When coders choose the wrong modifier for CPT 91035, claims may be denied. Always review payer-specific rules before submission.
2️⃣ Poor Claim Documentation
Improperly filled forms can lead to claim rejection. Ensure clarity in every billing field, including patient info, procedure details, and modifiers
???? Final Thoughts
Gastroesophageal reflux disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers bill under CPT Code 91035 to document GERD diagnosis accurately. Correct modifier usage and precise billing boost claim acceptance rates.