???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 is billed for the gastroesophageal reflux test. Accurate coding during claim submission is critical for correct reimbursements. Therefore, clinics often outsource medical billing 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 helps track acid reflux through pH monitoring. Detailed reporting ensures accurate reimbursement.

???? Applicable Modifiers for CPT 91035

Multiple modifiers can accompany CPT 91035 under unique clinical circumstances. Let’s review them:

• Modifier 26: Bills the professional component


• Modifier TC: Refers to the equipment and technician cost


• Modifier 52: Indicates reduced service.


• Modifier 53: Reports halted procedures.


• Modifier 59: Reports separate, non-overlapping procedures.


• Modifier 76: Shows repeat procedure by same provider


• Modifier 77: Reports repeat service by different provider

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

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

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

1️⃣ Incorrect Modifier Usage

If staff use modifier 77 instead of 59 for CPT 91035, claims may be denied. Always verify the correct modifier before submission.

2️⃣ Inaccurate Documentation

Missing patient or provider information can result in denied payments. Ensure completeness in every billing field, including documentation of service level

???? Final Thoughts

To detect reflux check here disease, doctors perform pH check here testing using telemetry electrodes.
Providers use CPT 91035 for reimbursement to ensure correct payment. Correct modifier usage and accurate coding enhance financial performance.