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...
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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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.
Common pulmonology billing challenges
PFT component bundling
Spirometry, volumes and DLCO combinations follow NCCI edits that change payment.
Bronchoscopy add-ons
Biopsies, EBUS and navigation codes must reflect every documented technique.
Hospital and ICU capture
Consults, rounds and critical care in multiple hospitals are easy to miss.
Oxygen and DME documentation
Home oxygen requires qualifying test results and certification forms.
Professional vs. technical PFTs
Hospital-based testing needs -26 modifiers for interpretation.
Prior authorization
Advanced imaging, biologics for asthma and some procedures need approval.
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
Key codes in pulmonology billing
| Code(s) | What it covers |
|---|---|
| 94010 / 94060 | Spirometry / spirometry before and after bronchodilator. |
| 94726 / 94727 | Plethysmography lung volumes / gas dilution or washout lung volumes. |
| 94729 | Diffusing capacity (DLCO), add-on to other PFT codes. |
| 94618 | Pulmonary stress testing (e.g., six-minute walk test). |
| 31622 / 31628 | Diagnostic bronchoscopy / bronchoscopy with transbronchial lung biopsy. |
| 31652 / 31653 | Bronchoscopy with endobronchial ultrasound (EBUS) sampling, 1–2 / 3 or more stations. |
| 99291 / 99292 | Critical 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.
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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.
Most common. You pay only on money collected.
Predictable for high-volume, low-complexity claims.
Dedicated billers working inside your systems.
Typical market ranges; actual quotes depend on claim volume, payer mix and scope. Compare quotes from several companies.
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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