???? Everything You Should Know About CPT Code 91035

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. Accurate coding during claim submission is critical for correct reimbursements. Therefore, providers often delegate billing tasks to streamline financial performance.

???? Understanding CPT 91035

The American Medical Association (AMA) created coding standards to simplify payments. CPT 91035 applies to a gastroesophageal reflux test, also known as the Bravo Capsule code. This procedure helps track acid reflux through pH monitoring. Proper documentation supports payer understanding.

???? CPT 91035 Modifier Details

Several 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: Used when service is partially reduced


• Modifier 53: Applied when treatment stops for patient safety


• Modifier 59: Reports separate, non-overlapping procedures.


• Modifier 76: Shows repeat procedure by same provider


• Modifier 77: Used when another physician performs the same test

⚖️ Difference Between CPT 91035 and 00812

CPT 91035 and CPT 00812 represent unrelated procedures.
CPT 91035 reports GERD testing, while CPT 00812 refers to anesthesia during colonoscopy

???? Billing Errors to Watch Out for in CPT 91035

1️⃣ Using the Wrong Modifier

Incorrect modifier selection for CPT 91035, it could lead to billing rejections. Always review payer-specific rules before submission.

2️⃣ Missing Details in Billing

Incomplete or incorrect details can lead to claim rejection. Ensure accuracy in every billing field, including patient info, procedure details, and modifiers

???? Conclusion

To website detect reflux disease, doctors perform pH testing website using telemetry electrodes.
Providers use CPT 91035 for reimbursement to receive appropriate reimbursement. Correct modifier usage and precise billing boost claim acceptance rates.