???? Understanding CPT Code 91035 for GERD Diagnosis

???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

To diagnose GERD effectively, providers perform acid level monitoring with telemetry pH electrode placement.
In medical billing, CPT Code 91035 is billed for the gastroesophageal reflux test. Accurate coding during claim submission is vital for correct reimbursements. Therefore, providers often partner with billing experts to streamline the revenue cycle.

???? What is CPT Code 91035?

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 applies to a website gastroesophageal reflux test, also known as the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Comprehensive details assist in justifying claims.

???? CPT 91035 Modifier Details

Various modifiers are used with CPT 91035 under different clinical circumstances. Let’s review them:

• Modifier 26: Bills the professional component


• 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: Reports separate, non-overlapping procedures.


• Modifier 76: Indicates repeated service.


• Modifier 77: Reports repeat service by different provider

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

These codes refer to different services.
CPT 91035 is used for reflux diagnosis, while CPT 00812 represents anesthesia services

???? Top CPT 91035 Coding Mistakes

1️⃣ Modifier Confusion

Incorrect modifier selection for CPT 91035, it could lead to billing rejections. Always review payer-specific rules before submission.

2️⃣ Missing Details in Billing

Missing patient or provider information can result in denied payments. Ensure completeness in every billing field, including all claim data.

???? Final Thoughts

Gastroesophageal reflux disease diagnosis involves analyzing acid backflow with website pH monitoring.
Providers submit CPT 91035 to insurers to document GERD diagnosis accurately. Correct modifier usage and precise billing boost claim acceptance rates.