???? A Comprehensive Guide to CPT Code 91035

Introduction:

To diagnose GERD effectively, providers perform acid level monitoring with telemetry pH electrode placement.
In medical billing, CPT Code 91035 is used for the gastroesophageal reflux test. Proper documentation during claim submission is vital 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) establishes guidelines for billing accuracy. CPT 91035 reports click here a gastroesophageal reflux test, also known as here the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Detailed reporting ensures accurate reimbursement.

???? CPT 91035 Modifier Details

Several modifiers can accompany CPT 91035 under different clinical circumstances. Let’s go through them:

• Modifier 26: Bills the professional component


• Modifier TC: Reports the procedural performance aspect.


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


• Modifier 53: Used if the procedure is discontinued


• Modifier 59: Used to prevent bundling errors


• Modifier 76: Indicates repeated service.


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

⚖️ Difference Between CPT 91035 and 00812

These codes 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 double-check the CPT pairing before submission.

2️⃣ Missing Details in Billing

Incomplete or incorrect details can lead to claim rejection. Ensure clarity in every billing field, including documentation of service level

???? Key Takeaway

GERD is diagnosed through pH monitoring that measures acid exposure in the esophagus.
Providers use CPT 91035 for reimbursement to receive appropriate reimbursement. Correct modifier usage and precise billing enhance financial performance.