???? A Comprehensive Guide to CPT Code 91035

Introduction:

The gastroesophageal reflux test monitors acid abnormalities in the stomach.
In medical billing, CPT Code 91035 is billed for the gastroesophageal reflux test. Proper documentation during claim submission is critical for correct reimbursements. Therefore, clinics often partner with billing experts to streamline cash flow.

???? What is CPT Code 91035?

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 applies to a gastroesophageal reflux test, popularly called the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Comprehensive details assist in justifying claims.

???? Applicable Modifiers for CPT 91035

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

• Modifier 26: Used for interpretation and report only


• Modifier TC: Reports the procedural performance aspect.


• Modifier 52: Used when service is partially reduced


• Modifier 53: Applied when treatment stops for patient safety


• Modifier 59: Indicates a distinct procedure performed the same day


• Modifier 76: Shows repeat procedure by same provider


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

⚖️ Relation Between CPT 91035 and 00812?

CPT 91035 and CPT 00812 represent unrelated procedures.
CPT 91035 covers check here gastroesophageal pH monitoring, while CPT 00812 is assigned for colonoscopy anesthesia billing.

???? 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 all claim data.

???? Key Takeaway

Gastroesophageal reflux disease diagnosis involves analyzing acid more info backflow with pH monitoring.
Providers submit CPT 91035 to insurers to document GERD diagnosis accurately. Correct modifier usage and proper claim preparation enhance financial performance.