Pulmonology Billing Services | Reduce Your Claim Denials to <1%
Transcure’s pulmonology billing services use AAPC-certified coders to achieve a 99% clean claim rate for pulmonary and critical care practices. We eliminate revenue leakage across your bronchoscopy, PFT, sleep study, and COPD claims by offering:
- Full compliance with HIPAA, CMS Critical Care Billing Guidelines, NCCI PPT edits, and Medicare LCD/NCD policies
- Accurately bill Bronchoscopy and EBUS Procedures (CPT 31622–31654) with AI validation of coding, modifiers, and NCCI bundling edits
- AI-Powered Pulmonary RCM (ELIXA, PRIA, CODIN & DEXA) to automate eligibility verification through payment reconciliation
- Maximize reimbursement for Pulmonary Function Testing by compliant billing for CPT 94010, 94726, 94729, 94618, and 95012
- Support billing for COPD (J44), Asthma (J45), and Sleep Apnea (G47.33) with PAP Documentation (CPT 95806–95811)
Our Success in Numbers
Trusted by
500+ Physicians
Catering to
40+ Specialties
1100+ Certified
Medical Billers & Coders
End-to-End
RPA Billing Solutions
Up to 98% First Pass
Clean Claim Rate
Why Do Practices Need Expert Pulmonology Billing Services For Better ROI?
Every pulmonology billing service runs into the same problems. Bronchoscopy codes are bundled incorrectly, Modifier 25 is missed on same-day PFTs, Pulmonary rehab sessions go undocumented, and CMS won’t pay without proper session-by-session records. These gaps are a big reason why pulmonary practice’s denial rate sits at nearly 18%.
Expert pulmonary medical billing services fix this. They offer accurate CPT and ICD-10 coding, correct modifier use, and full compliance with CMS’s pulmonary rehab and MIPS Value Pathway rules. Practices that outsource pulmonology billing to Transcure typically see a 20% increase in collections within the first month, with clean claim rates staying above 98%.
What Pulmonology Billing Services Does Transcure Offer to Maximize Reimbursement?
Transcure provides specialized pulmonology billing services to meet the unique needs of respiratory practices all around the USA. Here is an explanation of the pulmonary billing services we offer to reduce denials:
How Does Transcure Handle Different Laws and Challenges Affecting Pulmonology Billing?
Transcure assigns pulmonology-trained billing specialists who track CMS rule changes, apply correct codes, and prevent compliance violations. Our pulmonary medical billing services cover:
Pulmonary Rehabilitation Session Caps
CMS limits pulmonary rehabilitation to 36 one-hour sessions over 36 weeks. An additional 36 sessions are allowed only via the KX modifier and documented necessity. CODIN tracks each patient's session count in real time.
Home Oxygen Qualification Errors
Medicare requires a qualifying arterial blood gas or oximetry study performed at the “time of need” under NCD 240.2. Our pulmonology billing team verifies qualifying test documentation through ELIXA before every claim.
Sleep Study Billing Compliance
Sleep studies (CPT 95800–95811) require accurate Modifier -TC and -26 reporting when technical and professional services are billed separately. We review documentation and component billing to prevent avoidable denials.
False Claims Act (31 U.S.C. §§ 3729–3733)
Improper pulmonary billing, duplicate claims, or services lacking medical necessity can create FCA exposure. Civil penalties exceed $14,000 per claim. Our team runs pre-submission compliance audits to reduce that risk.
What Sub-specialties Does Transcure Support with Their Pulmonology Medical Billing Services?
Transcure provides specialized billing services for every pulmonology sub-specialty. Our billing experts ensure accurate coding, complete documentation, and compliance with Medicare and commercial payer guidelines across all pulmonary specialties, including:
Bronchoscopy Billing
Our pulmonology billing company handles diagnostic and therapeutic bronchoscopy billing, including biopsy and lavage add-ons. NCCI edits are also checked before every claim.
COPD Billing
We accurately bill COPD evaluations, exacerbation visits, and oxygen therapy. Acute flare-ups and chronic management services are billed separately when appropriate.
Spirometry & PFT Billing
Each PFT component is coded separately, from spirometry to lung volumes to DLCO testing. Nothing gets out the door without a physician's interpretation confirmed on file first.
Lung Cancer Billing
Our pulmonary billing team manages billing for lung cancer evaluations, bronchoscopy, EBUS staging, and biopsies. Every claim meets payer coding and documentation requirements.
Polysomnography (Sleep Study) Billing
We select the correct code for in-lab or home sleep studies based on how each was performed. AHI results and physician interpretations are verified before claims are sent out.
Interstitial Lung Disease (ILD) Billing
Transcure supports billing for ILD evaluations, pulmonary function tests, and long-term follow-up visits. Every claim is reviewed for accurate coding and complete documentation.
Pulmonology Billing Services Serving Every State in the United States
At Transcure, you get specialized pulmonology billing services across the United States. This allows us to cater to pulmonary and sleep medicine practices in every state according to their healthcare requirements.
Which Pulmonology CPT & ICD-10 Codes Can Our Billing Experts Handle?
Our experienced team handles coding for pulmonary diagnostics, interventional pulmonology, sleep studies, and chronic respiratory conditions. We report the right pulmonology CPT codes and pulmonology ICD-10 codes across:
31622 to 31656
- Bronchoscopy CPT codes for pulmonary procedures
94010 to 94070
- Pulmonary function CPT codes for lung testing
94726 to 94729
- Lung volume & DLCO CPT codes for diagnostics
95800 to 95811
- Sleep study CPT codes for apnea evaluation
99291 to 99292
- Critical care CPT codes for ICU services
E0424 to E0444
- HCPCS codes for home oxygen therapy
J44.0 to J44.9
- COPD ICD 10 codes for chronic lung disease
J45.20 to J45.998
- Asthma ICD 10 for severity levels
G47.30 to G47.39
- Sleep apnea ICD 10 codes
Is Your Pulmonary Documentation Costing You Revenue?
Pulmonary claims are most often denied because documentation fails to prove medical necessity. It’s not because the CPT code is wrong. This usually happens when pulmonary practices miss changes to CMS billing rules.
In fact, CMS added over 3,750 new NCCI code-pair restrictions just last quarter, and rework on a single denied claim runs $25 to $118. To avoid this, CODIN, Transcure’s AI coding agent, reviews documentation, modifiers, and medical necessity before every claim is submitted. This reduces denials, accelerates payments, and protects your revenue.
Why Should You Outsource Pulmonology Billing Services to Transcure?
Transcure provides specialized pulmonology RCM solutions that improve reimbursement and simplify your billing operations. Our pulmonology billing specialists offer the following pulmonology billing services:
Procedure Billing Experts
We accurately bill bronchoscopy, EBUS, PFTs, sleep studies, lung biopsies and critical care using the latest CMS coding and documentation requirements.
Dedicated Account Manager
You get a dedicated pulmonology billing account manager who tracks every claim, denial, and payer follow-up and is available 24/7 to resolve queries.
AI Denial Prevention
Transcure’s AI agents review medical necessity, modifiers, NCCI edits, and payer rules before every claim is submitted. It prevents avoidable denials.
Multi-Specialty Pulmonology Billing
Our pulmonology billing services support practices in COPD, asthma, ILD, pulmonary hypertension, and sleep medicine. Every claim is handled with specialty-specific expertise.
Lower Billing Costs
Hiring a certified pulmonology coder costs $50,000+ annually. With Transcure, you only pay a fixed 5% of the monthly collections we bring in.
Revenue Reporting
We provide weekly/monthly reports of collections, A/R aging, denial trends, and payer performance, so you always know where your revenue stands.
Our Certifications
Transcure’s pulmonology billing specialists hold industry-recognized certifications. We make sure every pulmonary claim meets CMS requirements, payer guidelines, and specialty-specific coding standards.
What Pulmonology EHR Systems Are Supported by Transcure?
Transcure’s pulmonology billing team plugs directly into the EHR your respiratory practice already uses, preserving existing spirometry results and bronchoscopy notes. We pull data from your systems, so you don’t have to learn new software or a new workflow.
Trusted by Thousands Across the Nation
Our pulmonology billing company is rated top-tier by pulmonology practices on Google, Trustpilot, and every major review site.
What Do Practices Say About Our Pulmonology Medical Billing Services?
See how pulmonology practices we partner with turn PFT and bronchoscopy billing headaches into steady revenue. Real stories, real numbers.
Jackie Judd
Practice Manager
Wilson Creek Internal Medicine
As a practice manager, I was looking to streamline the medical billing process. I tried other companies, but they were all complicated and took too much of my time. Fortunately, I found Transcure. They excel in tailoring solutions to fit my requirements.
Amber Vaughan
Office Manager
Idaho Kidney & Hypertension Institute
We are a large practice with 15 providers. Transcure has been working with us for the last 5 years. This billing company has been a great asset to us. I work with Transcure and they provide everything I ask for. The team is friendly and very pleasant to work with.
Ashlee Rose
Practice Manager
Harding Memorial Healthcare
We’ve been working with Transcure for 8 years now and I just wanted to say how happy we are with their services. They always get back to us quickly and are very easy to work with. They get my bills paid in record time and help us to generate millions in revenue.
Frequently Asked Questions About Pulmonology Billing Services
Curious what pulmonology practices ask most about our pulmonary medical billing services, pulmonary rehab compliance, and CMS reimbursement rules? We’ve got answers.
What is Pulmonology Billing?
Pulmonology billing is the entire process of turning respiratory care into paid claims. This means assigning the correct CPT, ICD-10, and HCPCS codes to each service, submitting the claim, and following it through to payment.
Why Does My Practice Need Modifier 25 or Modifier 59 on Certain Claims?
Modifier 25 is used when a doctor performs a regular office visit and a separate, significant procedure on the same day. Alternatively, Modifier 59 is used when two procedures appear to be bundled as a single service but were actually performed at separate sites or for genuinely distinct reasons.
What Is CPT Code 94060 Used For?
CPT 94060 is used for spirometry with pre- and post-bronchodilator testing to evaluate airflow obstruction and bronchodilator response. Claims require documented medical necessity, complete test results, and compliance with payer documentation requirements.
How Do You Bill for a Pulmonary Function Test?
Pulmonary function tests are billed using CPT 94010 for spirometry, 94060 for spirometry with bronchodilator response, 94726 for lung volume measurement, and 94729 for diffusion capacity (DLCO). Claims must include documented medical necessity, physician interpretation, and the correct modifiers.
What are the Common Pulmonology CPT Codes?
Common pulmonology CPT codes include 31622–31656 for bronchoscopy procedures, 94010–94070 for pulmonary function testing (PFT), 94726–94729 for lung volume and DLCO testing, and 95800–95811 for sleep studies. They also include 99291–99292 for critical care services and 94625–94626 for pulmonary rehabilitation.
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