???? 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 used for the gastroesophageal reflux test. Proper documentation during claim submission is essential for correct reimbursements. Therefore, clinics often partner with billing experts to streamline cash flow.

???? What is CPT Code 91035?

The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 represents a gastroesophageal reflux test, also known as the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Comprehensive details assist in justifying claims.

???? CPT 91035 Modifier Details

Various modifiers are used with CPT 91035 under specific clinical circumstances. Let’s review them:

• Modifier 26: Used for interpretation and report only


• Modifier TC: Refers to the equipment and technician cost


• Modifier 52: Applied when part of the procedure is omitted


• Modifier 53: Applied when treatment stops for patient safety


• Modifier 59: Indicates a distinct procedure performed the same day


• Modifier 76: Shows repeat procedure by same provider


• Modifier 77: Indicates separate provider involvement.

⚖️ Difference Between CPT 91035 and 00812

CPT 91035 and CPT 00812 website represent unrelated procedures.
CPT 91035 is used for reflux diagnosis, more info while CPT 00812 represents anesthesia services

???? Top CPT 91035 Coding Mistakes

1️⃣ Modifier Confusion

If staff use modifier 77 instead of 59 for CPT 91035, the reimbursement can be delayed. Always verify the correct modifier before submission.

2️⃣ Missing Details in Billing

Improperly filled forms can lead to claim rejection. Ensure clarity in every billing field, including patient info, procedure details, and modifiers

???? Final Thoughts

GERD is diagnosed through pH monitoring that measures acid exposure in the esophagus.
Providers use CPT 91035 for reimbursement to ensure correct payment. Correct modifier usage and precise billing optimize the revenue cycle.