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Pulmonology billing

Pulmonology Billing Services

Pulmonary function testing, bronchoscopy, sleep studies and ICU care, pulmonologists bill across many settings. Specialist billers capture every test and every visit.

  • PFT, spirometry and diffusion testing coded by components
  • Bronchoscopy and EBUS procedures coded from reports
  • Critical care and hospital services reconciled daily

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96%
Clean-claim rate target
20%
Revenue missed in multi-site practices
< 35
Days in A/R goal
Overview

What pulmonology billing covers

Pulmonology practices bill office visits, a large menu of pulmonary function tests, procedures like bronchoscopy and EBUS, and hospital and critical care services. Pulmonary function testing is coded by component, spirometry, lung volumes, diffusion capacity, bronchodilator response, with bundling rules between them.

Bronchoscopy codes depend on what was done: diagnostic inspection, washings, biopsies, transbronchial needle aspiration or endobronchial ultrasound, each with add-on codes. Many pulmonologists also cover ICUs, where critical care time and separately billable procedures must be captured carefully.

Additional services, home oxygen certifications, inhaler teaching, six-minute walk tests and sleep medicine, add more claim types. A pulmonology billing partner reconciles hospital and office charges, verifies authorizations for advanced procedures and keeps diagnosis links strong for medical necessity.

Why it's hard

Common pulmonology billing challenges

01

PFT component bundling

Spirometry, volumes and DLCO combinations follow NCCI edits that change payment.

02

Bronchoscopy add-ons

Biopsies, EBUS and navigation codes must reflect every documented technique.

03

Hospital and ICU capture

Consults, rounds and critical care in multiple hospitals are easy to miss.

04

Oxygen and DME documentation

Home oxygen requires qualifying test results and certification forms.

05

Professional vs. technical PFTs

Hospital-based testing needs -26 modifiers for interpretation.

06

Prior authorization

Advanced imaging, biologics for asthma and some procedures need approval.

What's included

What a pulmonology billing partner should handle

  • PFT and spirometry component coding
  • Bronchoscopy, EBUS and biopsy coding
  • Critical care and inpatient charge reconciliation
  • Professional and technical component billing
  • Oxygen and DME certification support
  • Biologic prior authorization for severe asthma
  • Sleep study coordination and billing
  • Denial management and appeals
  • Patient statements and payment plans
  • Provider and site performance reports
Coding focus

Key codes in pulmonology billing

Code(s)What it covers
94010 / 94060Spirometry / spirometry before and after bronchodilator.
94726 / 94727Plethysmography lung volumes / gas dilution or washout lung volumes.
94729Diffusing capacity (DLCO), add-on to other PFT codes.
94618Pulmonary stress testing (e.g., six-minute walk test).
31622 / 31628Diagnostic bronchoscopy / bronchoscopy with transbronchial lung biopsy.
31652 / 31653Bronchoscopy with endobronchial ultrasound (EBUS) sampling, 1–2 / 3 or more stations.
99291 / 99292Critical care, first 30–74 minutes and each additional 30 minutes.

Code examples are for orientation only. Always code from the current CPT®, HCPCS and ICD-10-CM code sets and payer policies.

Link tests to diagnoses

Pulmonary testing is covered when linked to symptoms or conditions under payer policies. Document the clinical reason for each test and avoid routine repeat testing without a change in condition.

How it works

Find the right billing partner in four steps

1

Share your goals

Tell us your specialty, monthly claim volume, EHR and the problems you want fixed, denials, slow A/R or staffing gaps.

2

Get a free audit

We review a sample of your claims and aging report to show where revenue is leaking and what a specialist could recover.

3

Compare vetted companies

Shortlist billers with proven pulmonology experience, transparent pricing and verified client reviews.

4

Onboard with confidence

Sign a BAA, connect your EHR and clearinghouse, and track clean-claim rate, days in A/R and collections from month one.

Compare

Top-rated medical billing companies

Billing companies listed on BillerFirms, ranked by client reviews. Ask each one about their pulmonology experience.

See all companies
5.0 5 reviews

Who We Are We are Prime Medical Billing Solutions, LLC, a results-driven medical billing and revenue cycle partner headquartered in Atlanta, Georgia. Since about 2015, we have operated with the belief that true value lies in partnering, rather than merely contracting, with providers to ensure personalized attention and peak revenue performance. Founded by seasoned billing professionals with 20+ years of combined expert experience, our home office in Atlanta supports both individual practices and larger provider groups. Our team is passionate about maximizing reimbursements and simplifying the billing journey step by step. What Services We Offer We provide a comprehensive suite of services designed to optimize every phase of the revenue cycle: Claims processing & billing management, including electronic, UB‑04, and HCFA‑1500 formats Accounts receivable and collections, focusing on paid-to...

Atlanta, Georgia
Founded 2015
Claims ProcessingDenial ManagementCredentialing (Payer & License)
No reviews yet

GreenSense Billing is a trusted leader in medical billing and revenue cycle management, providing comprehensive solutions tailored to the unique needs of healthcare providers across the United States. Our mission is to streamline administrative complexities, optimize reimbursements, and enhance financial performance, allowing medical professionals to focus on delivering exceptional patient care. Our Services • We offer end-to-end medical billing and revenue management solutions, including: •  Medical Billing & Coding - Accurate claims processing to maximize reimbursements and minimize denials. •  Revenue Cycle Management (RCM) - A holistic approach to managing claims, payments, and collections. •  Provider Credentialing - Seamless enrollment with insurance networks to ensure timely reimbursements. •  Financial Solutions - Data-driven insights and financial reporting to optimize practice...

Las Vegas, Nevada
Founded 2003
Claims ProcessingDenial ManagementRevenue Cycle Management
No reviews yet

Let’s face it, medical billing shouldn’t be the most challenging part of running a practice. At Medical Lean Management, we take the chaos out of revenue cycle management so you can get back to what matters: delivering excellent patient care. Based in Corona, California, we’re not just another faceless billing company, we’re your partners in efficiency, here to simplify the financial side of healthcare. Why Us? Because We Get It. Paperwork piles up. Claims get denied. Regulations keep changing. It’s enough to make anyone’s head spin. That’s where we step in. We don’t just process claims, we optimize your entire revenue cycle, cutting through the red tape to get you paid faster and with fewer headaches. Our goal? To make your billing so smooth, you’ll wonder how you ever managed without us. Here’s How We Help: ✔ Fewer Denials, More Revenue - Our precision-driven approach slashes claim den...

Corona, California
Founded 1994
Claims ProcessingDenial ManagementRevenue Cycle Management
No reviews yet

Overview & Mission Access Revenue Hawaii, founded in 2022 in Holualoa, Hawai‘i, is a specialized medical billing and revenue cycle management (RCM) company with a primary focus on behavioral and mental health providers. Drawing deeply from social work roots, the leadership team recognized the administrative friction mental health professionals face, credentialing delays, complex payer regulations, EMR documentation requirements, and chose to build a firm that helps clinicians focus fully on patient care. Their mission centers on removing financial and operational barriers so therapists, counselors, and behavioral health groups can thrive financially while delivering quality care to Hawai‘i’s communities. Origin Story & Local Presence The company was born out of a clear insight: behavioral health providers in Hawai‘i suffer unique administrative challenges. From intricate Medicaid billing...

Chandler, Arizona
Founded 2007
Claims ProcessingDenial ManagementRevenue Cycle Management
Pricing

How much does pulmonology billing cost?

Most billing companies charge a percentage of what they actually collect, so their incentive matches yours. Complex specialties sit at the higher end of the range because of prior authorizations, modifiers and appeal work.

Percentage of collections
4% - 7%

Most common. You pay only on money collected.

Per claim
$4 - $10

Predictable for high-volume, low-complexity claims.

Hourly / FTE
$12 - $35/hr

Dedicated billers working inside your systems.

Typical market ranges; actual quotes depend on claim volume, payer mix and scope. Compare quotes from several companies.

FAQ

Pulmonology billing FAQs

By component, such as spirometry, lung volumes and diffusion capacity, with add-on and bundling rules that determine which codes can be reported together.

With 31652 for sampling one or two mediastinal or hilar lymph node stations and 31653 for three or more, plus add-on codes for peripheral EBUS when applicable.

Yes, when the patient is critically ill and time is documented, using 99291 and 99292.

Yes, billers help ensure qualifying test results and certification documents are complete for oxygen suppliers.

Common reasons include missing authorizations, bundling errors between PFT codes and weak diagnosis links.

Typically 4% to 7% of collections.

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