
???? Everything You Should Know About 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 vital for correct reimbursements. Therefore, clinics often delegate billing tasks to streamline financial performance.
???? Understanding CPT 91035
The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 represents a gastroesophageal reflux test, commonly here referred to as the here Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Proper documentation supports payer understanding.
???? Applicable Modifiers for CPT 91035
Various modifiers can accompany CPT 91035 under different clinical circumstances. Let’s review them:
- Modifier 26: Used for interpretation and report only
- 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: Used to prevent bundling errors
- 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 reports GERD testing, while CPT 00812 refers to anesthesia during colonoscopy
???? 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 result in denied payments. Ensure completeness in every billing field, including all claim data.
???? Key Takeaway
Gastroesophageal reflux disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers submit CPT 91035 to insurers to document GERD diagnosis accurately. Correct modifier usage and precise billing boost claim acceptance rates.