???? Understanding CPT Code 91035 for GERD Diagnosis
Introduction:
GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 applies to 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) sets medical coding rules for reimbursement. CPT 91035 applies to a gastroesophageal reflux test, also known as the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Detailed reporting ensures accurate reimbursement.
???? Modifiers for CPT Code 91035
Multiple modifiers are used with CPT 91035 under unique clinical circumstances. Let’s break down them:
- Modifier 26: Bills the professional component
- Modifier TC: Refers to the equipment and technician cost
- Modifier 52: Indicates reduced service.
- 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 get more info different services.
CPT 91035 is used for reflux diagnosis, get more info 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
Improperly filled forms can cause reimbursement delays. 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.