???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

The gastroesophageal reflux test monitors acid abnormalities in the stomach.
In medical billing, CPT Code 91035 is used for the gastroesophageal reflux test. Coding precision during claim submission is vital for correct reimbursements. Therefore, providers often outsource medical billing to streamline cash flow.

???? Understanding CPT 91035

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 applies to a gastroesophageal reflux test, popularly called the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Proper documentation supports payer understanding.

???? Modifiers for CPT Code 91035

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

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


• Modifier TC: Reports the procedural performance aspect.


• Modifier 52: Indicates reduced service.


• Modifier 53: Applied when treatment stops for patient safety


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


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


• Modifier 77: Reports repeat service by different provider

⚖️ Difference Between CPT 91035 and 00812

No, they are not related.
CPT 91035 covers gastroesophageal click here pH monitoring, while CPT 00812 refers to anesthesia during colonoscopy

???? Billing Errors to Watch Out for in CPT 91035

1️⃣ Modifier Confusion

Incorrect modifier selection for CPT 91035, claims may be denied. Always verify the correct modifier before submission.

2️⃣ Inaccurate Documentation

Improperly filled forms 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 check here esophagus.
Providers bill under CPT Code 91035 to ensure correct payment. Correct modifier usage and proper claim preparation enhance financial performance.