What we handle for pulmonology practices
Billers are assigned by specialty, so the person working your claims already knows your codes and your payers.
Pulmonary function testing
Spirometry, lung volumes and diffusion capacity billed with correct component splits.
Bronchoscopy
Diagnostic and therapeutic bronchoscopy coded to what was performed, including biopsy and lavage.
Sleep medicine
In-lab and home sleep testing billed within payer coverage criteria.
Critical care
Time-based critical care billed to documented minutes, separated from other same-day services.
Where pulmonology claims usually go wrong
These are the four issues we see most often when we take over a pulmonology practice.
Critical care time documentation
Critical care is billed in minutes and must exclude separately billable procedures. Vague notes lose the claim on audit.
PFT component splits
Billing global when the equipment belongs to the hospital causes duplicate denials.
Home oxygen documentation
Oxygen requires documented qualifying test results. Without them the DME claim fails.
Sleep study coverage criteria
Home versus in-lab coverage differs by payer and by patient risk factors.
How we work
Eligibility, every day
Every next-day scheduled patient is verified for active coverage before the visit.
Charges validated
Codes and documentation are checked after the note is signed, before the claim is submitted.
Denials appealed
Every denial is reviewed, corrected and resubmitted. Nothing is written off by default.
Monthly reporting
Paid claims and AR aging reports so you can see exactly where your money is.
Pulmonology billing questions
Something not covered here? Call (833) 305-5528.
Do you bill home sleep testing?
Yes, where the payer covers it for that patient.
Can you handle critical care billing?
Yes, including the time documentation requirements and modifier use.
Do you bill home oxygen and DME?
Yes, with the required qualifying documentation.