???? Everything You Should Know About CPT Code 91035

???? Everything You Should Know About CPT Code 91035

Introduction:

GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 applies to the gastroesophageal reflux test. Coding precision during claim submission is critical for correct reimbursements. Therefore, healthcare organizations often partner with billing experts to streamline financial performance.

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 represents a gastroesophageal reflux test, commonly referred read more to as the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Detailed reporting ensures accurate reimbursement.

???? Applicable Modifiers for CPT 91035

Multiple modifiers can accompany CPT 91035 under specific 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: Shows repeat procedure by same provider


• Modifier 77: Reports repeat service by different provider

⚖️ Relation Between CPT 91035 and 00812?

These codes refer to different services.
CPT 91035 is used for reflux diagnosis, while CPT 00812 represents anesthesia services

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

1️⃣ Using the Wrong Modifier

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

Missing patient or provider information can result in denied payments. Ensure clarity in every billing field, including patient info, procedure details, and modifiers

???? Key Takeaway

Gastroesophageal reflux disease diagnosis involves analyzing acid website backflow with pH monitoring.
Providers submit CPT 91035 to insurers to receive appropriate reimbursement. Correct modifier usage and accurate coding enhance financial performance.