???? Everything You Should Know About CPT Code 91035
???? Everything You Should Know About 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. Accurate coding during claim submission is critical for correct reimbursements. Therefore, healthcare organizations 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 helps track acid reflux through pH monitoring. Proper documentation supports payer understanding.
???? CPT 91035 Modifier Details
Various modifiers may be appended to CPT 91035 under specific clinical circumstances. Let’s go through 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: 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
⚖️ Relation Between CPT 91035 and 00812?
CPT 91035 and CPT 00812 click here represent unrelated procedures.
CPT 91035 covers click here gastroesophageal pH monitoring, while CPT 00812 refers to anesthesia during colonoscopy
???? Common Mistakes to Avoid When Billing CPT Code 91035
1️⃣ Modifier Confusion
Incorrect modifier selection for CPT 91035, it could lead to billing rejections. Always verify the correct modifier 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
???? 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 enhance financial performance.