Pulmonology billing
Clean, compliant billing for high-complexity respiratory and sleep care.
Pulmonology bridges inpatient critical care, outpatient evaluation, diagnostic testing and sleep medicine. We integrate directly into your EHR to ensure every procedure component is accurately captured, medical necessity is documented, and complex multi-specialty claims are processed without delay.
Services we provide for pulmonology practices
Specialty-trained coders and billers who know your workflows, payers and compliance requirements inside out.
- Office & outpatient pulmonology consultation billing
- Pulmonary Function Testing (PFT) multi-component billing
- Sleep medicine & polysomnography claims management
- Inpatient & critical care ventilator management billing
- Bronchoscopy & interventional pulmonology billing
- DME tracking & compliance (CPAP/oxygen)
- Home Sleep Apnea Testing (HSAT) billing
- High-cost biologics prior authorization & tracking
Codes we manage every day
A representative sample of the CPT, ICD-10 and modifier expertise our team applies to pulmonology claims.
Common CPT codes
- 94010Spirometry
- 94060Bronchodilation responsiveness
- 94729Diffusing capacity (DLCO)
- 95810, 95811Polysomnography (with/without CPAP)
- 31622–31625Bronchoscopy (diagnostic/biopsy)
- 99291, 99292Critical care services
Common diagnosis codes
- J44.9Chronic obstructive pulmonary disease
- J45.909Unspecified asthma, uncomplicated
- G47.33Obstructive sleep apnea
- J96.01Acute respiratory failure with hypoxia
- J84.112Idiopathic pulmonary fibrosis
Modifiers we manage
- 26Professional component
- TCTechnical component
- 25Separate E/M with same-day spirometry
- 59 / XSDistinct procedural service
Common billing challenges we solve
- Professional vs. technical component split rejections
- Same-day PFT and E/M bundling denials
- Strict sleep-medicine medical necessity documentation
- Inpatient split-care charge capture gaps
- DME compliance documentation for oxygen and CPAP
Payers we work with
- Medicare & Medicare Advantage (strict PFT guidelines)
- Medicaid & Managed Medicaid
- Commercial carriers (BCBS, UHC, Aetna, Cigna, Humana)
- Tricare & VA Community Care Network
- DOL Federal Black Lung Program
Why pulmonology practices choose Core MBS
Respiratory & sleep coding specialists
Defensive modifier applications on multi-component days
Streamlined DME & biologics prior-authorization support
Frictionless EHR integration with zero data silos
Let's get your revenue cycle healthy.
Send us a note for a free, no-obligation billing review — we'll show you exactly where revenue is leaking and how we'd fix it.
- Corembs5@gmail.com
- corembs.com
- 30 N Gould St, Ste N, Sheridan, WY 82801