Pulmonology Billing Services in the US

Pulmonologists are overwhelmed by the rising number of patient visits, and notable surgeries like lobectomy (removing a lung lobe), pneumonectomy (removing an entire lung), and wedge resection (removing a small lung section) leave no spare time for the providers to complete their billing tasks timely.

At Bilnow, with our professional pulmonology billing services, you can cover all steps of the insurance billing process. We ensure that providers are rightfully reimbursed without losing their focus on rendering patient care.

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Why Do Pulmonologists trust Bilnow for Pulmonology Billing?

Partnering with us ensures a healthcare practice that is never short of revenue and is always up to delivering the best care to its patients. Our team handles your billing process with efficiency. We ensure zero errors in diagnostic codes specific to pulmonology practice. We prepare thorough records of the patient demographic and diagnostics to eliminate the chances of errors. Apart from all this, we aim to maximize your practice revenue while adhering to HIPAA compliance.

Our billing solutions promise:

  • Coding With Compliance
  • Zero Revenue Loss
  • Fully HIPAA-Compliant
  • 99% First Pass Claim Rate
  • Standardized RCM Process
  • Dedicated Specialized Team
  • Real-Time Reporting

Consolidate All Your Billing, Payments, and Collections Under One Roof

Our Comprehensive Pulmonology Billing Services Cover:

Allergy therapy & home ventilation billing

We’re not just limited to hospitals or clinical billing; we’re sailing allergy therapy and home ventilation services. Our experts focus on accurate coding and documentation while using appropriate CPT codes like 95115, 95117, and 95004-95078. Our billers also consider ICD-10 codes, which are necessary for efficient claim preparation to avoid denials.

CPT codes for allergy therapy and home ventilation:

  • 95115: For the single injection
  • 95117: For multiple injections
  • 95004-95078: These are used to bill for different allergy testing procedures, including percutaneous (scratch, prick) and intracutaneous (intradermal) tests.

Pulmonology Function Test (PFT) Billing

Using the appropriate Current Procedural Terminology (CPT) codes for the function test billing. Whether it's for basic spirometry or bronchodilation responsiveness, we ensure accurate documentation and adherence to payer guidelines while coding the rendered services or preparing claims.

CPT codes for the pulmonary function test:

  • 94070: To report bronchospasm provocation evaluation
  • 94200: For maximal voluntary ventilation (MVV) testing
  • 94640: For pressurized or non-pressurized inhalation treatment for acute airway obstruction
  • 94726: To report lung volume measurement
  • 94727: For gas diffusion testing
  • 94729: To report the single-breath carbon monoxide diffusing capacity (DLCO) test

Sleep Studies & CPAP Therapy Billing

For sleep study and CPAP therapy billing, our coding experts use specific CPT codes (like 95800, 95801, 95806, 95810, and 95811) and strictly adhere to billing guidelines for care services like polysomnography and CPAP titration. We ensure that your claims, documents, diagnostic codes, and rendered services align with payer policies.

CPT codes for sleep studies:

  • 95800: For the in-home sleep study
  • 95800: For the in-home sleep study
  • 95806: For the in-facility sleep study
  • 95810: For Polysomnography (PSG)
  • 95811: For diagnostic sleep study and CPAP titration study

Bronchology & Bronchial Ultrasound Billing

For billing EBUS services, we use CPT codes 31652 (for one or two mediastinal/hilar lymph node stations) and 31653 (for three or more), with an add-on code 31654 used when performing EBUS for peripheral lesions in addition to primary bronchoscopy procedures.

CPT codes for bronchology and bronchial ultrasound:

  • 31652: For endobronchial ultrasound (EBUS) guided transracial or transbronchial sampling (eg, aspiration[s]/ biopsy[ies]), one or two mediastinal or hilar lymph node stations or structures are utilized when one sample of two or one proximal structure.
  • 31653: For endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal or hilar lymph node stations.
  • 31654: For transendoscopic endobronchial ultrasound (EBUS) (e.g, intervention(s) for peripheral lesion(s) (List separately in addition to code for primary procedure (s) is an “add-on” (ZZZ) code used when peripheral lesions (distal to the hilar structures)

Chronic respiratory disease billing

When billing for chronic respiratory diseases, we utilize CPT codes like 94625 and 94626 for pulmonary rehabilitation and ICD-10 codes such as J40-J44 for conditions like COPD and chronic bronchitis.

CPT codes for chronic respiratory disease:

  • 4625: For Pulmonary Diagnostic Testing and Therapies
  • 94626: For outpatient pulmonary rehabilitation

Pulmonology Billing Future Trends & Industry Insights

Growing demand for pulmonologists:
Pulmonary diseases account for 8.9% of all specialists.

Rising COPD:
Treatment costs and COPD hospitalization contribute to significant revenue loss due to inaccurate coding and underbilling.

High claim denial rates:
30% of the claims are denied on the first submission, with 32% due to coding errors.

Build Your Perfect Lineup With Bilnow

Billing errors, denied claims, and slow reimbursements suffocate your practice’s profitability, but it does not have to be this way. At Bilnow, we don’t just process claims; we optimize your revenue. Our solutions reduce your stress and increase your payments up to 30% by making it easier for your patients to pay their bills 24/7.

Pre-Visit Billing

With BilNow's pre-visit billing services, you can review your patients' financial situations in advance. This technique helps practices reduce outstanding balances and ensure they get paid faster.

Mailed Bills

Providers can send professionally printed and customizable mailed bills. Also, you can upload, review, edit, and approve your bills with just the click of a button. With our customizable templates, providers can easily add/edit messages, specify the forms of payments they accept, and change the color of their statements. We help you make your bills easy to understand.

Flexible payment methods

1 out of 4 people in the USA cannot afford to pay their bills in one go, resulting in delays in reimbursements. We help you win with our multiple payment options, especially those your payers prefer. Our comprehensive payment solutions allow you to accept mobile, online, in-office, mail, and phone payments and convert your past-due A/R into received payments.

E-Bill Notices via Text & Email

The sooner payers receive their bills, the sooner you’ll get your reimbursements. Decrease the average days to payment from 20 to 9 by pairing the convenience of E-Bill Notices with the reliability of Mailed Bills and accelerate your payments with us.

Payment reminders

Put your billing on autopilot with Bilnow. Our payment reminder services help you send pre-collection billing reminders. It is an efficient and cost-effective way to manage your receivables before they become past/due.

Revenue Cycle Management

From pre-claim services to patient payments and collections, Bilnow’s expert coders and billers will manage your insurance and patient billing and spare you time to focus on your patients and provide the care they need.

Request additional information on pulmonology billing and optimizing your billing and payment workflows with Bilnow.

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Frequently Asked Questions

Commonly used codes in pulmonology include CPT codes for pulmonary function tests (like 94070, 94200, 94726), sleep studies (95800–95811), bronchoscopy procedures (31652–31654), and therapy services for chronic respiratory diseases (94625, 94626). Accurate use of these codes ensures proper reimbursement and compliance.
To reduce denials, ensure precise medical coding, proper documentation of services, timely claim submissions, and adherence to payer-specific guidelines. Regular audits and billing staff training also help maintain a low denial rate.
Look for a provider with experience in pulmonology coding, a high claim acceptance rate, HIPAA compliance, transparent reporting, and a dedicated team familiar with payer policies and specialty-specific procedures.
Challenges include complex coding requirements, high denial rates due to documentation errors, evolving insurance regulations, and managing billing for both clinical and home-based care, like sleep studies or home ventilation.
Pulmonologists, sleep specialists, respiratory therapy providers, and clinics offering lung function testing or chronic respiratory care all benefit from specialized pulmonology billing support.