???? Everything You Should Know About CPT Code 91035

Introduction:

The gastroesophageal reflux test monitors acid abnormalities in the stomach.
In medical billing, CPT Code 91035 applies to the gastroesophageal reflux test. Proper documentation during claim submission is essential for correct reimbursements. Therefore, clinics often outsource medical billing to streamline the revenue cycle.

???? What is CPT Code 91035?

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 represents a gastroesophageal reflux test, also known as the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Detailed reporting ensures accurate reimbursement.

???? CPT 91035 Modifier Details

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

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


• Modifier TC: Refers to the equipment and technician cost


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


• Modifier 53: Used if the procedure is discontinued


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


• Modifier 76: Indicates repeated service.


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

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

No, they are not related.
CPT 91035 covers gastroesophageal pH monitoring, more info while CPT 00812 is assigned for colonoscopy anesthesia billing.

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

1️⃣ Using the Wrong Modifier

Incorrect modifier selection for CPT 91035, claims may be denied. Always verify the correct modifier before submission.

2️⃣ Poor Claim Documentation

Missing patient or provider information can lead to claim rejection. Ensure clarity in every billing field, including all claim data.

???? Key Takeaway

GERD is diagnosed through pH monitoring that measures click here acid exposure in the esophagus.
Providers submit CPT 91035 to insurers to ensure correct payment. Correct modifier usage and precise billing boost claim acceptance rates.