???? 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, providers often delegate billing tasks to streamline financial performance.

???? Understanding CPT 91035

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 represents a gastroesophageal reflux 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.

???? Modifiers for CPT Code 91035

Several modifiers are used with CPT 91035 under specific clinical circumstances. Let’s break down them:

• Modifier 26: Used for interpretation and report only


• Modifier TC: Reports the procedural performance aspect.


• Modifier 52: Indicates reduced service.


• Modifier 53: Used if the procedure is discontinued


• Modifier 59: Used to prevent bundling errors


• Modifier 76: Applied when test is repeated on same day


• Modifier 77: Indicates separate provider involvement.

⚖️ Difference Between CPT 91035 and 00812

No, they click here are not related.
CPT 91035 reports GERD testing, click here while CPT 00812 refers to anesthesia during colonoscopy

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

1️⃣ Using the Wrong Modifier

When coders choose the wrong modifier for CPT 91035, the reimbursement can be delayed. Always double-check the CPT pairing before submission.

2️⃣ Poor Claim Documentation

Improperly filled forms can cause reimbursement delays. Ensure clarity in every billing field, including patient info, procedure details, and modifiers

???? Conclusion

To detect reflux disease, doctors perform pH testing using telemetry electrodes.
Providers bill under CPT Code 91035 to ensure correct payment. Correct modifier usage and accurate coding optimize the revenue cycle.