???? Understanding CPT Code 91035 for GERD Diagnosis
Introduction:
To diagnose GERD effectively, providers perform acid level monitoring with telemetry pH electrode placement.
In medical billing, CPT Code 91035 is used for the gastroesophageal reflux test. Coding precision during claim submission is vital 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 check here test, popularly called the 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 unique clinical circumstances. Let’s review them:
- Modifier 26: Used for interpretation and report only
- Modifier TC: Reports the procedural performance aspect.
- Modifier 52: Indicates reduced service.
- Modifier 53: Used if the procedure is discontinued
- Modifier 59: Used to prevent bundling errors
- Modifier 76: Applied when test is repeated on same day
- Modifier 77: Indicates separate provider involvement.
⚖️ Difference Between CPT 91035 and 00812
CPT 91035 and check here CPT 00812 represent unrelated procedures.
CPT 91035 reports GERD testing, while CPT 00812 refers to anesthesia during colonoscopy
???? Common Mistakes to Avoid When Billing CPT Code 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 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 proper claim preparation enhance financial performance.