Pulmonary Function Test Billing
PFTs involve multiple components: spirometry (94010), lung volumes (94726), DLCO (94729), and bronchodilator response (94060). Each is billed separately, and missing any component leaves revenue uncollected.
Pulmonology Billing Experts
Pulmonology Medical Billing Services
Revenue cycle management for pulmonology practices handling PFT billing, bronchoscopy coding, and sleep study reimbursement.
190+
Pulmonology Practices
97.8%
Clean Claim Rate
$4.5M
Revenue Recovered
24hr
Claim Submission
Overview
The Diagnostic and Procedural Scope of Pulmonology Billing
Pulmonology billing covers diagnostic testing, procedural interventions, and chronic disease management, often for the same patient in the same visit. Pulmonary function tests, bronchoscopy procedures, and critical care billing each follow distinct coding frameworks. Getting all three right under one practice requires specialty-level billing expertise.
We manage pulmonology billing with workflows designed for the diagnostic and procedural volume this specialty generates. From spirometry to bronchoscopy, from sleep studies to ventilator management, our coders handle the full scope of pulmonary medicine billing.
Challenges
Common Pulmonology billing Challenges We Solve
Every Pulmonology billing team deals with payer delays, coding nuance, and collection leakage. We tighten those weak points before they turn into write-offs.
Bronchoscopy Procedure Coding
Diagnostic bronchoscopy (31622), with biopsy (31625), with BAL (31624), and with brushing (31623) follow hierarchical coding rules. Multiple procedures during the same session require correct modifier application.
Critical Care and Ventilator Management
Pulmonologists providing ICU care bill critical care codes (99291-99292) alongside ventilator management (94002-94005). Time documentation must clearly separate critical care time from ventilator management time.
Sleep Study Billing Complexity
In-lab polysomnography (95810-95811) and home sleep testing (95800-95801) have different reimbursement rates and pre-authorization requirements. Technical and professional component splits must be correctly applied.
Services
Complete Pulmonology billing Services
Support spans the full revenue cycle, from front-end verification to denial recovery and reporting.
Pulmonary function test billing (spirometry, lung volumes, DLCO)
Bronchoscopy procedure coding with multi-procedure modifier management
Critical care and ventilator management billing
Sleep study billing (PSG, MSLT, home sleep testing)
Chronic disease management (COPD, asthma, pulmonary fibrosis)
Prior authorization for biologic drugs and advanced diagnostics
Coverage
Serving Pulmonology billing Teams Nationwide
We support independent practices, multisite groups, and growing provider organizations with flexible workflows.
Independent physician groups
Multi-location practices
Private equity backed platforms
Hospital-owned outpatient groups
Guide
The Complete Guide to Pulmonology billing
Pulmonology billing covers diagnostic testing, procedural interventions, and chronic disease management, often for the same patient in the same visit. Pulmonary function tests, bronchoscopy procedures, and critical care billing each follow distinct coding frameworks. Getting all three right under one practice requires specialty-level billing expertise.
We manage pulmonology billing with workflows designed for the diagnostic and procedural volume this specialty generates. From spirometry to bronchoscopy, from sleep studies to ventilator management, our coders handle the full scope of pulmonary medicine billing.
Common Questions
Frequently Asked Questions About Pulmonology billing
Answers to the questions practice owners and managers ask most often before switching billing partners.
How do you bill for pulmonary function tests?
We bill each PFT component separately: spirometry (94010), flow-volume loop (94375), lung volumes (94726), DLCO (94729), and bronchodilator response (94060). When all components are performed during the same session, we ensure each code is submitted with appropriate documentation. Missing even one component can leave $30 to $75 unbilled.
What is the correct coding for bronchoscopy procedures?
Diagnostic bronchoscopy (31622) is the base code. When additional procedures are performed (biopsy 31625, BAL 31624, brushing 31623), we apply the appropriate modifier to the secondary procedures. Some combinations bundle under CCI edits, and we know which require modifier 59 for separate reimbursement.
Can you handle critical care billing for pulmonologists?
Yes. Critical care billing (99291 for the first 30-74 minutes, 99292 for each additional 30 minutes) requires precise time documentation excluding procedures with separate CPT codes. We review ICU notes daily to ensure time documentation supports the billed critical care level.
How do you manage sleep study billing?
We handle both in-lab polysomnography (95810 attended, 95811 with CPAP titration) and home sleep testing (95800-95801). For practices that own their sleep lab, we bill both technical and professional components. For practices using independent labs, we bill the professional interpretation only.
What prior authorization is required for pulmonology drugs?
Biologics for severe asthma (omalizumab, mepolizumab, dupilumab) and antifibrotic drugs (pirfenidone, nintedanib) require prior authorization with clinical documentation including spirometry results, exacerbation history, and previous treatment failures.
How do you bill for COPD and asthma management visits?
COPD and asthma management visits are billed using standard E/M codes with appropriate diagnosis codes. When combined with PFTs or nebulizer treatments, we ensure all services are captured. For patients in pulmonary rehabilitation programs, we bill 94625-94626 for the rehab sessions separately.
Comparison
How We Compare for Pulmonology billing
The difference is operational discipline. We focus on clean submissions, fast follow-up, and transparency.
Criteria
My Medical Bill Solution
Typical Provider
Specialty-specific billing workflows
Included
Often generic
Dedicated account ownership
Yes
Shared queue
Denial root-cause reporting
Weekly
Ad hoc
Claim submission speed
Within 24 hours
Varies
Communication cadence
Planned check-ins
Reactive only
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