Services · Pulmonology coding
Any biller you hire should know 94010 from 94060 — cold
Coding accuracy is where pulmonology revenue is won or lost. Before you sign with anyone, test them against the code families below. The ones who answer without looking anything up are the ones worth paying.
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The working set a pulmonology-competent coder lives in
Pulmonary function testing. 94010 spirometry, 94060 with bronchodilator, 94726 lung volumes, 94729 DLCO, 94618 pulmonary stress testing, 94760/94761 oximetry — with component billing (26/TC) determined by site of service.
Bronchoscopy. 31622 diagnostic through 31628 transbronchial biopsy, brushing, BAL, EBUS — with NCCI edit review on every multi-procedure session.
Respiratory treatment. 94640 inhalation treatment and 94664 inhaler technique (once per day, never with 94640 — the kind of rule that quietly costs practices money, and a perfect interview question for a prospective biller).
Sleep medicine. 95810 polysomnography, titration, home sleep tests, and professional-component reads.
E/M. 99202–99215 by MDM or total time, 99291 critical care — coded from documentation, not habit.
Modifiers. 25, 26, TC, 59, 76: the five that decide most pulmonology payment disputes.
Ask for a coding audit — and judge the answer
Any billing service worth hiring will review a sample of your recent encounters against documentation: undercoding that leaves money unbilled, overcoding that invites payer audits, missed components, modifier errors. Ask what a coding review includes, whether certified coders (AAPC/CPC) do the work, and whether findings come with dollar impact. A provider who won't show you their audit process is asking you to buy blind.
Pulmonology coding, answered
What certifications should a billing company's coders have?
AAPC certification (CPC) is the baseline signal. Better: ask how much of their current volume is pulmonology — certification without specialty reps still misses bundling and component rules.
Should coding change how our physicians document?
Coding should follow documentation. But a good coding partner tells you when documentation habitually leaves revenue unsupported — with the exact note element that's missing.
Test the coding before you sign
Get competitive quotes, then put each biller through the code families above. Fluency shows immediately.
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