???? Everything You Should Know About CPT Code 91035

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

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 represents a website gastroesophageal reflux test, popularly called the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Proper documentation supports payer understanding.

???? Applicable Modifiers for CPT 91035

Several modifiers can accompany CPT 91035 under specific clinical circumstances. Let’s review them:

Modifier 26: Bills the professional component

Modifier TC: Covers the technical component

Modifier 52: Indicates reduced service.

Modifier 53: Reports halted procedures.

Modifier 59: Used to prevent bundling errors

Modifier 76: Shows repeat procedure by same provider

Modifier 77: Indicates separate provider involvement.

⚖️ Difference Between CPT 91035 and 00812

These codes refer to different services.
CPT 91035 reports GERD testing, here while CPT 00812 is assigned for colonoscopy anesthesia billing.

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

1️⃣ Incorrect Modifier Usage

Incorrect modifier selection for CPT 91035, claims may be denied. Always review payer-specific rules before submission.

2️⃣ Poor Claim Documentation

Missing patient or provider information can cause reimbursement delays. Ensure completeness in every billing field, including documentation of service level

???? Key Takeaway

To detect reflux disease, doctors perform pH testing using telemetry electrodes.
Providers submit CPT 91035 to insurers to receive appropriate reimbursement. Correct modifier usage and proper claim preparation optimize the revenue cycle.