???? Understanding CPT Code 91035 for GERD Diagnosis

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. 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) establishes guidelines for billing accuracy. CPT 91035 applies to a check here gastroesophageal reflux test, commonly referred to as the Bravo Capsule code. This procedure monitors acid pH via mucosal-attached telemetry electrodes. Comprehensive details assist in justifying claims.

???? Modifiers for CPT Code 91035

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

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


• Modifier TC: Covers the technical component


• 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: Indicates repeated service.


• Modifier 77: Reports repeat service by different provider

⚖️ Is CPT Code 91035 Related to CPT Code 00812?

These codes refer to different services.
CPT 91035 is used for reflux diagnosis, 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, claims may be denied. Always review payer-specific rules before submission.

2️⃣ Missing Details in Billing

Improperly filled forms can lead to claim rejection. Ensure completeness in every billing field, including all claim data.

???? Final Thoughts

To detect reflux disease, doctors here perform pH testing using telemetry electrodes.
Providers bill under CPT Code 91035 to document GERD diagnosis accurately. Correct modifier usage and precise billing enhance financial performance.