???? 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 applies to the gastroesophageal reflux test. Accurate coding during claim submission is vital for correct reimbursements. Therefore, providers often partner with billing experts to streamline cash flow.

???? Understanding CPT 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. Detailed reporting ensures accurate reimbursement.

???? Modifiers for CPT Code 91035

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

• Modifier 26: Bills the professional component


• Modifier TC: Covers the technical component


• Modifier 52: Used when service is partially reduced


• Modifier 53: Reports halted procedures.


• Modifier 59: Used to prevent bundling errors


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


• Modifier 77: Reports repeat service by different provider

⚖️ Difference Between CPT 91035 and 00812

CPT 91035 and CPT check here 00812 represent unrelated procedures.
CPT 91035 reports GERD testing, while CPT 00812 is assigned for colonoscopy anesthesia billing.

???? 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 review payer-specific rules before submission.

2️⃣ Poor Claim Documentation

Missing patient or provider information can cause reimbursement delays. Ensure completeness in every billing field, including documentation of service level

???? Key Takeaway

To detect reflux read more disease, doctors perform pH testing using telemetry electrodes.
Providers bill under CPT Code 91035 to receive appropriate reimbursement. Correct modifier usage and proper claim preparation optimize the revenue cycle.