???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

The gastroesophageal reflux test monitors acid abnormalities in the stomach.
In medical billing, CPT Code 91035 is used for the gastroesophageal reflux test. Accurate coding during claim submission is critical for correct reimbursements. Therefore, healthcare organizations often partner with billing experts to streamline the revenue cycle.

???? What is CPT Code 91035?

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 reports a gastroesophageal reflux test, here popularly called the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Comprehensive details assist in justifying claims.

???? Modifiers for CPT Code 91035

Multiple modifiers can accompany CPT 91035 under different clinical circumstances. Let’s go through them:

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


• Modifier TC: Covers the technical component


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


• Modifier 53: Reports halted procedures.


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


• Modifier 76: Shows repeat procedure by same provider


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

⚖️ 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 Using the Wrong Modifier

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.

???? Key Takeaway

GERD is diagnosed through pH monitoring that measures acid exposure in more info the esophagus.
Providers bill under CPT Code 91035 to ensure correct payment. Correct modifier usage and accurate coding optimize the revenue cycle.