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

Introduction:

To diagnose GERD effectively, providers perform acid level monitoring with telemetry pH electrode placement.
In medical billing, CPT Code 91035 is used for the gastroesophageal reflux test. Coding precision during claim submission is critical for correct reimbursements. Therefore, healthcare organizations often delegate billing tasks to streamline financial performance.

???? Definition and Explanation of CPT Code 91035

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 reports a gastroesophageal reflux test, popularly called 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 specific clinical circumstances. Let’s go through them:

• Modifier 26: Bills the professional component


• Modifier TC: Refers to the equipment and technician cost


• Modifier 52: Indicates reduced service.


• 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: Used when another physician performs the same test

⚖️ Difference Between CPT 91035 and 00812

CPT 91035 more info and CPT 00812 represent unrelated procedures.
CPT 91035 covers gastroesophageal pH monitoring, while CPT 00812 is assigned for colonoscopy anesthesia billing.

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

1️⃣ Incorrect Modifier Usage

If staff use modifier 77 instead of 59 for CPT 91035, it could lead to billing rejections. Always review payer-specific rules before submission.

2️⃣ Poor Claim Documentation

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 perform pH testing click here using telemetry electrodes.
Providers bill under CPT Code 91035 to ensure correct payment. Correct modifier usage and precise billing optimize the revenue cycle.