???? A Comprehensive Guide to CPT Code 91035



???? 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. Accurate coding during claim submission is critical for correct reimbursements. Therefore, healthcare organizations often partner with billing experts to streamline the revenue cycle.






???? What is CPT Code 91035?


The American Medical Association (AMA) establishes guidelines for billing accuracy. read more 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. Proper documentation supports payer understanding.






???? CPT 91035 Modifier Details


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




  • Modifier 26: Bills the professional component

  • 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 are not related.
CPT 91035 reports GERD testing, while CPT 00812 refers to anesthesia during colonoscopy






???? Billing Errors to Watch Out for in CPT 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 documentation of service level






???? Final Thoughts


Gastroesophageal reflux disease diagnosis involves analyzing acid read more backflow with pH monitoring.
Providers use CPT 91035 for reimbursement to receive appropriate reimbursement. Correct modifier usage and precise billing boost claim acceptance rates.

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