???? 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 applies to the gastroesophageal reflux test. Proper documentation during claim submission is essential for correct reimbursements. Therefore, clinics 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 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

Multiple modifiers can accompany CPT 91035 under unique clinical circumstances. Let’s review them:

• Modifier 26: Used for interpretation and report only


• Modifier TC: Covers the technical component


• Modifier 52: Used when service is partially reduced


• Modifier 53: Applied when treatment stops for patient safety


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


• Modifier 76: Indicates repeated service.


• Modifier 77: Reports repeat service by different provider

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

No, they are not related.
CPT 91035 is used for reflux diagnosis, while website CPT 00812 represents anesthesia services

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

1️⃣ Using the Wrong Modifier

Incorrect modifier selection for CPT 91035, it could lead to billing rejections. Always review payer-specific rules before submission.

2️⃣ Missing Details in Billing

Missing patient or provider information can result in denied payments. Ensure clarity in every billing field, including documentation of service level

???? Final Thoughts

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