???? Everything You Should Know About CPT Code 91035



???? Everything You Should Know About 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. 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) sets medical coding rules for reimbursement. CPT 91035 click here applies to a gastroesophageal reflux check here test, also known as the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Detailed reporting ensures accurate reimbursement.






???? Applicable Modifiers for CPT 91035


Multiple modifiers can accompany CPT 91035 under different 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: 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 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 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 optimize the revenue cycle.

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