???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 applies to the gastroesophageal reflux test. Coding precision during claim submission is vital for correct reimbursements. Therefore, clinics often delegate billing tasks to streamline financial performance.

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 reports a gastroesophageal reflux test, also known read more as the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Detailed reporting ensures accurate reimbursement.

???? Applicable Modifiers for CPT 91035

Various modifiers may be appended to CPT 91035 under different clinical circumstances. Let’s go through them:

• Modifier 26: Indicates the physician’s portion of service.


• Modifier TC: Covers the technical component


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


• Modifier 53: Reports halted procedures.


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


• 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 website CPT 00812 represent unrelated procedures.
CPT 91035 covers gastroesophageal pH monitoring, while CPT 00812 refers to anesthesia during colonoscopy

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

1️⃣ Incorrect Modifier Usage

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

Incomplete or incorrect details can lead to claim rejection. Ensure accuracy in every billing field, including patient info, procedure details, and modifiers

???? Conclusion

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 accurate coding optimize the revenue cycle.