PFT bundling denials
Component tests billed alongside comprehensive codes that include them. We apply the combinations correctly.
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Pulmonology medical billing services
Pulmonology bills pulmonary function testing, sleep medicine, bronchoscopy, critical care and the chronic management of COPD and asthma. The billing turns on testing component rules, bronchoscopy bundling and capturing the care-management and remote monitoring services pulmonary patients qualify for.
What makes pulmonology billing different
General billers treat every specialty the same. These are the rules, code families and payer habits that decide whether pulmonology claims pay the first time.
- Pulmonary function tests (94010–94729) have specific combinations and bundling; spirometry with bronchodilator (94060) replaces 94010 rather than adding to it.
- Bronchoscopy codes (31622–31654) bundle diagnostic components; add-ons for navigation, EBUS and biopsy follow specific rules.
- Home sleep testing and polysomnography have component billing and strict medical-necessity criteria.
- COPD and asthma patients commonly qualify for chronic care management, remote monitoring and pulmonary rehabilitation referrals.
Denials we see most in pulmonology
Every denial gets a root cause, a fix and a feedback loop, so the same denial stops coming back.
Bronchoscopy add-on errors
Add-ons denied without the right base code or documentation. Coded from the procedure report.
Sleep study medical necessity
Studies denied for criteria not documented. We check criteria before scheduling.
How Core MB bills for pulmonology
A dedicated team that already knows your payers' rules, plus the reporting to prove it is working. Credentialing for new pulmonology providers runs in the same system, tracked live in your client portal.
- PFT and sleep testing billing with correct combinations and components.
- Bronchoscopy coding from the procedure report with NCCI edits applied.
- CCM and RPM programs for chronic pulmonary patients.
Everything in the service
The full revenue cycle as standard for pulmonology practices, priced on what we collect for you. Take all of it, or start with one piece such as AR recovery or credentialing.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
- Provider credentialing and payer enrollment
Pulmonology billing questions
Why do pulmonary function test claims get denied?
Bundling. Several PFT codes include others, and billing both is denied. We apply the right combinations for what was performed.
Do you bill bronchoscopy procedures?
Yes, including navigation and EBUS add-ons, coded from the procedure report under current bundling rules.
Can pulmonary patients be enrolled in remote monitoring?
Often, yes. COPD patients in particular qualify for RPM and CCM, and both add recurring monthly revenue.
How do we get started with Core MB for pulmonology billing?
Send us your specialty, provider count and monthly claim volume through the quote form and we will come back with a written proposal. Transitions run alongside your current billing so nothing is dropped, and credentialing for new pulmonology providers can start at the same time.
Find out what your pulmonology billing is leaving on the table
Send us a snapshot of your current billing and we will come back with a quote and a realistic view of recoverable revenue.