???? Understanding CPT Code 91035 for GERD Diagnosis

???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 is used for the gastroesophageal reflux test. Proper documentation during claim submission is critical for correct reimbursements. Therefore, clinics often outsource medical billing to streamline cash flow.

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 reports here a gastroesophageal reflux test, here 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

Multiple modifiers can accompany CPT 91035 under unique clinical circumstances. Let’s review 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: Used if the procedure is discontinued


• Modifier 59: Used to prevent bundling errors


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


• Modifier 77: Indicates separate provider involvement.

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

No, they are not related.
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

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

2️⃣ Poor Claim Documentation

Improperly filled forms can cause reimbursement delays. Ensure clarity in every billing field, including documentation of service level

???? Conclusion

To detect reflux disease, doctors perform pH testing using telemetry electrodes.
Providers use CPT 91035 for reimbursement to receive appropriate reimbursement. Correct modifier usage and accurate coding optimize the revenue cycle.