???? Understanding CPT Code 91035 for GERD Diagnosis
Introduction:
GERD diagnosis requires precise acid monitoring between stomach and esophagus.
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 financial performance.
???? Understanding CPT 91035
The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 reports a gastroesophageal reflux test, more info popularly called the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. 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: Indicates the physician’s portion of service.
- Modifier TC: Covers the technical component
- Modifier 52: Applied when part of the procedure is omitted
- Modifier 53: Applied when treatment stops for patient safety
- Modifier 59: Reports separate, non-overlapping procedures.
- Modifier 76: Shows repeat procedure by same provider
- Modifier 77: Reports repeat service by different provider
⚖️ Relation Between CPT 91035 and 00812?
These codes refer more info to different services.
CPT 91035 covers gastroesophageal pH monitoring, while CPT 00812 is assigned for colonoscopy anesthesia billing.
???? Top CPT 91035 Coding Mistakes
1️⃣ Incorrect Modifier Usage
If staff use modifier 77 instead of 59 for CPT 91035, claims may be denied. Always verify the correct modifier before submission.
2️⃣ Inaccurate Documentation
Incomplete or incorrect details can lead to claim rejection. 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.