???? 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.

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 applies to a gastroesophageal reflux test, also known as the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Proper documentation supports payer understanding.

???? CPT 91035 Modifier Details

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

• Modifier 26: Used for interpretation and report only


• 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: Shows repeat procedure by same provider


• Modifier 77: Reports repeat service by different provider

⚖️ Relation Between CPT 91035 and 00812?

CPT 91035 and CPT 00812 represent click here unrelated procedures.
CPT 91035 covers gastroesophageal pH monitoring, click here while CPT 00812 refers to anesthesia during colonoscopy

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

1️⃣ Incorrect Modifier Usage

When coders choose the wrong modifier for CPT 91035, the reimbursement can be delayed. Always double-check the CPT pairing 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

Gastroesophageal reflux disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers bill under CPT Code 91035 to ensure correct payment. Correct modifier usage and proper claim preparation enhance financial performance.