???? Understanding CPT Code 91035 for GERD Diagnosis
Introduction:
GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 is billed for the gastroesophageal reflux test. Proper documentation 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.
???? CPT 91035 Modifier Details
Various modifiers may be appended to CPT 91035 under different clinical circumstances. Let’s go through 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: Reports halted procedures.
- 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 to different services.
CPT 91035 is used for reflux diagnosis, while CPT 00812 is assigned for colonoscopy anesthesia billing.
???? Top CPT 91035 Coding Mistakes
1️⃣ Modifier Confusion
Incorrect modifier selection for CPT 91035, it could lead to billing rejections. Always review payer-specific rules before submission.
2️⃣ Missing Details in Billing
Missing patient or provider information can result in denied payments. Ensure completeness in every billing field, including all claim data.
???? Key Takeaway
Gastroesophageal reflux website disease diagnosis involves analyzing acid website backflow with pH monitoring.
Providers submit CPT 91035 to insurers to document GERD diagnosis accurately. Correct modifier usage and precise billing boost claim acceptance rates.