???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 is billed for the gastroesophageal reflux test. Accurate coding during claim submission is critical 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 referred to as the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Detailed reporting ensures accurate reimbursement.

???? Applicable Modifiers for CPT 91035

Multiple modifiers are used with CPT 91035 under unique 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: Reports halted procedures.


• 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, check here they are not related.
CPT 91035 check here 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 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 testing using telemetry electrodes.
Providers use CPT 91035 for reimbursement to ensure correct payment. Correct modifier usage and accurate coding enhance financial performance.