???? A Comprehensive Guide to CPT Code 91035
Introduction:
The gastroesophageal reflux test monitors acid abnormalities in the stomach.
In medical billing, CPT Code 91035 is billed for the gastroesophageal reflux test. Proper documentation during claim submission is essential for correct reimbursements. Therefore, clinics often outsource medical billing to streamline cash flow.
???? What is CPT Code 91035?
The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 represents a gastroesophageal read more reflux test, 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
Various modifiers may be appended to CPT 91035 under specific clinical circumstances. Let’s break down them:
- Modifier 26: Used for interpretation and report only
- Modifier TC: Covers the technical component
- Modifier 52: Applied when part of the procedure is omitted
- Modifier 53: Reports halted procedures.
- Modifier 59: Indicates a distinct procedure performed the same day
- Modifier 76: Shows repeat procedure by same provider
- Modifier 77: Used when another physician performs the same test
⚖️ Is CPT Code 91035 Related to CPT Code 00812?
No, they are not website related.
CPT 91035 covers gastroesophageal pH monitoring, while CPT 00812 refers to anesthesia during colonoscopy
???? Billing Errors to Watch Out for in CPT 91035
1️⃣ Incorrect Modifier Usage
If staff use modifier 77 instead of 59 for CPT 91035, the reimbursement can be delayed. Always double-check the CPT pairing 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
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 boost claim acceptance rates.