???? Everything You Should Know About CPT Code 91035
???? A Comprehensive Guide to CPT Code 91035
Introduction:
GERD diagnosis requires precise acid monitoring between stomach and esophagus.
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 outsource medical billing to streamline cash flow.
???? Definition and Explanation of CPT Code 91035
The American Medical Association (AMA) sets medical coding rules for reimbursement. CPT 91035 applies to a gastroesophageal reflux test, also known as the website Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Comprehensive details assist in justifying claims.
???? Modifiers for CPT Code 91035
Multiple modifiers are used with CPT 91035 under specific clinical circumstances. Let’s break down them:
- Modifier 26: Bills the professional component
- 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: Reports separate, non-overlapping procedures.
- Modifier 76: Indicates repeated service.
- Modifier 77: Reports repeat service by different provider
⚖️ Is CPT Code 91035 Related to CPT Code 00812?
No, they are not website 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
Incomplete or incorrect details can lead to claim rejection. Ensure accuracy in every billing field, including patient info, procedure details, and modifiers
???? Key Takeaway
GERD is diagnosed through pH monitoring that measures acid exposure in the esophagus.
Providers submit CPT 91035 to insurers to document GERD diagnosis accurately. Correct modifier usage and proper claim preparation boost claim acceptance rates.