???? Understanding CPT Code 91035 for GERD Diagnosis

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 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 monitors acid pH via mucosal-attached telemetry electrodes. Comprehensive details assist in justifying claims.

???? Modifiers for CPT Code 91035

Several 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: Indicates reduced service.


• Modifier 53: Reports halted procedures.


• Modifier 59: Indicates a distinct procedure performed the same day


• Modifier 76: Indicates repeated service.


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

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

These codes website refer to different services.
CPT 91035 covers gastroesophageal pH monitoring, while CPT 00812 refers to anesthesia during colonoscopy

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

1️⃣ Modifier Confusion

If staff use modifier 77 instead of 59 for CPT 91035, the reimbursement can be delayed. Always review payer-specific rules before submission.

2️⃣ Inaccurate Documentation

Incomplete or incorrect details can result in denied payments. Ensure accuracy in every billing field, including patient info, procedure details, and modifiers

???? Key Takeaway

Gastroesophageal reflux disease diagnosis involves analyzing here acid backflow with pH monitoring.
Providers submit CPT 91035 to insurers to receive appropriate reimbursement. Correct modifier usage and accurate coding boost claim acceptance rates.