???? Understanding CPT Code 91035 for GERD Diagnosis

???? 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 billed for the gastroesophageal reflux test. Proper documentation during claim submission is essential for correct reimbursements. Therefore, clinics often delegate billing tasks to streamline cash flow.

???? What is CPT Code 91035?

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 represents a gastroesophageal reflux test, popularly called the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Proper documentation supports payer understanding.

???? CPT 91035 Modifier Details

Various modifiers may be appended to CPT 91035 under specific clinical circumstances. Let’s break down them:

• Modifier 26: Bills the professional component


• Modifier TC: Reports the procedural performance aspect.


• Modifier 52: Indicates reduced service.


• Modifier 53: Reports halted procedures.


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


• Modifier 76: Indicates repeated service.


• Modifier 77: Indicates separate provider involvement.

⚖️ Difference Between CPT 91035 and 00812

CPT 91035 and CPT 00812 represent unrelated procedures.
CPT 91035 reports GERD testing, while CPT 00812 represents anesthesia services

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

Incomplete or incorrect details can result in denied payments. Ensure accuracy in every billing field, including all claim data.

???? Conclusion

GERD check here is diagnosed through pH monitoring that measures acid website exposure in the esophagus.
Providers submit CPT 91035 to insurers to ensure correct payment. Correct modifier usage and proper claim preparation optimize the revenue cycle.