???? 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. Coding precision during claim submission is essential for correct reimbursements. Therefore, providers often partner with billing experts to streamline the revenue cycle.
???? What is CPT Code 91035?
The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 represents a gastroesophageal reflux test, commonly referred to as the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Proper documentation supports payer understanding.
???? Applicable Modifiers for CPT 91035
Various modifiers can accompany CPT 91035 under different clinical circumstances. Let’s review them:
- Modifier 26: Indicates the physician’s portion of service.
- 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: Used to prevent bundling errors
- Modifier 76: Indicates repeated service.
- Modifier 77: Indicates separate provider involvement.
⚖️ Is CPT Code 91035 Related to CPT Code 00812?
No, they are not related.
CPT 91035 reports click here 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 accuracy in every billing field, including patient info, procedure details, and modifiers
???? Conclusion
GERD is diagnosed through click here pH monitoring that measures acid exposure in the esophagus.
Providers bill under CPT Code 91035 to ensure correct payment. Correct modifier usage and accurate coding enhance financial performance.