???? Everything You Should Know About 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. Coding precision during claim submission is vital for correct reimbursements. Therefore, healthcare organizations often outsource medical billing to streamline cash flow.

???? What is CPT Code 91035?

The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 applies to a gastroesophageal reflux test, popularly called 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

Multiple 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: Covers the technical component


• Modifier 52: Used when service is partially reduced


• Modifier 53: Applied when treatment stops for patient safety


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


• Modifier 76: Applied when test is repeated on same day


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

⚖️ Difference Between CPT 91035 and 00812

CPT check here 91035 and CPT 00812 represent unrelated procedures.
CPT 91035 is used for reflux diagnosis, while CPT 00812 represents anesthesia services

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

1️⃣ Incorrect Modifier Usage

Incorrect modifier selection for CPT 91035, the reimbursement can be delayed. Always verify the correct modifier before submission.

2️⃣ Missing Details in Billing

Improperly filled forms can result in denied payments. Ensure accuracy in every billing field, including all claim data.

???? Final Thoughts

GERD is website diagnosed through pH monitoring that measures acid exposure in the esophagus.
Providers submit CPT 91035 to insurers to receive appropriate reimbursement. Correct modifier usage and proper claim preparation optimize the revenue cycle.