???? 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. Accurate coding during claim submission is vital for correct reimbursements. Therefore, providers often delegate billing tasks to streamline the revenue cycle.

???? What is CPT Code 91035?

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 applies to a gastroesophageal reflux website test, commonly referred to as the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Comprehensive details assist in justifying claims.

???? CPT 91035 Modifier Details

Various modifiers may be appended to CPT 91035 under different clinical circumstances. Let’s break down them:

• Modifier 26: Bills the professional component


• Modifier TC: Refers to the equipment and technician cost


• Modifier 52: Applied when part of the procedure is omitted


• Modifier 53: Applied when treatment stops for patient safety


• Modifier 59: Used to prevent bundling errors


• Modifier 76: Indicates repeated service.


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

⚖️ Relation Between CPT 91035 and 00812?

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

???? Common Mistakes to Avoid When Billing CPT Code 91035

1️⃣ Modifier Confusion

When coders choose the wrong modifier for CPT 91035, the reimbursement can be delayed. Always verify the correct modifier before submission.

2️⃣ Inaccurate Documentation

Missing patient or provider information can lead to claim rejection. Ensure completeness in every billing field, including documentation of service level

???? Conclusion

Gastroesophageal reflux disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers use CPT 91035 for reimbursement to ensure correct payment. Correct modifier usage and precise billing enhance financial performance.