???? 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 used for the gastroesophageal reflux test. Coding precision during claim submission is critical for correct reimbursements. Therefore, healthcare organizations 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. Proper documentation supports payer understanding.

???? Applicable Modifiers for CPT 91035

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

• Modifier 26: Used for interpretation and report only


• 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 more info reports GERD testing, while more info CPT 00812 refers to anesthesia during colonoscopy

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

1️⃣ Using the Wrong Modifier

When coders choose the wrong modifier for CPT 91035, the reimbursement can be delayed. Always verify the correct modifier before submission.

2️⃣ Inaccurate Documentation

Incomplete or incorrect details can lead to claim rejection. Ensure completeness in every billing field, including all claim data.

???? Key Takeaway

Gastroesophageal reflux disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers submit CPT 91035 to insurers to receive appropriate reimbursement. Correct modifier usage and precise billing optimize the revenue cycle.