Pulmonology Billing in 2025

Maximize revenue, reduce denials, and ensure compliance with expert pulmonology billing services from Mastermind Healthcare – trusted by clinics across the USA and India.

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Expert Pulmonology Billing for Maximum Reimbursement

At Mastermind Healthcare, we specialize in pulmonology billing for clinics managing respiratory conditions like COPD, asthma, and pulmonary fibrosis. Our certified coders (CPC, CCS-P) ensure accurate claims, faster reimbursements, and full compliance with CMS, Medicare, and private payer guidelines.

We help reduce claim denials by up to 70% and improve cash flow through precise coding, timely submissions, and proactive follow-ups.

Pulmonology Billing Services

Common Pulmonology CPT & ICD-10 Codes (2025)

CPT Code Description ICD-10 Example
94010Simple spirometryJ44.9 (COPD)
94640Nebulizer treatmentJ45.909 (Asthma)
94729Lung volume measurementJ84.10 (Interstitial lung disease)
99213–99215Office visit (E/M)R06.02 (Shortness of breath)

Success Story: 68% Fewer Denials in 90 Days

Client: Pulmonary Associates of Chennai
Challenge: High denial rate (42%) due to incorrect coding and missing documentation.
Solution: We conducted a full billing audit, retrained staff, and implemented our denial prevention protocol.
Result: Denials dropped to 14%, and revenue increased by 31% in 3 months.

Why Choose Our Pulmonology Billing Services?

100% Compliance

HIPAA, NABH, and CMS-compliant processes ensure audit readiness and data security.

Data-Driven Insights

Monthly reports with KPIs: denial rate, AR days, collection rate, and more.

How It Works: AI-Powered Billing Accuracy

Smart Coding. Zero Guesswork.

Our AI-assisted system cross-checks every claim against 2025 CPT rules, payer policies, and historical denial patterns — reducing errors before submission.

  • Real-time code validation
  • Denial risk scoring
  • Auto-documentation alerts

Frequently Asked Questions About Pulmonology Medical Billing

Common CPT codes in pulmonology include 94010 (spirometry), 94640 (nebulizer treatment), 94729 (lung volume measurements), 94618 (CPAP/BiPAP management), and 99213–99215 for evaluation and management (E/M) visits. Accurate use of these codes ensures proper reimbursement and reduces claim denials.

Reduce claim denials by ensuring accurate coding, complete clinical documentation, timely filing, and regular audits. Partnering with a specialized pulmonology billing service can help identify risk areas before submission. We offer a free denial risk assessment to help you improve clean claim rates.

CPT 94010 refers to spirometry with interpretation and report only, while CPT 94060 includes both spirometry and bronchodilator responsiveness testing. Proper documentation of pre- and post-bronchodilator results is required to bill 94060. Using the wrong code can lead to underpayment or denials.

Pulmonary function tests (PFTs) are billed using specific CPT codes based on the type of test performed. Common codes include:
  • 94010 – Simple spirometry
  • 94375 – Complete PFT (includes spirometry, lung volumes, and diffusion capacity)
  • 94729 – Lung volume measurement
  • 94150 – Diffusion capacity (DLCO)
Always ensure medical necessity is documented and that tests are performed under physician supervision.

Yes, telehealth services are billable in pulmonology using codes such as 99202–99215 with modifiers like 95 or GT, depending on payer guidelines. Medicare, Medicaid, and many private insurers cover virtual visits for chronic conditions like COPD and asthma. Ensure proper documentation and use of approved telehealth platforms.

Essential documentation includes patient history, physical exam findings, medical necessity for tests, test results with interpretation, treatment plans, and progress notes. For procedures like bronchoscopy or PFTs, detailed reports with physician signatures are required. Incomplete records are a leading cause of claim denials.

Outsourcing pulmonology billing to a specialty-focused provider can improve revenue cycle efficiency, reduce errors, and save time. Specialized billers understand complex coding rules, payer policies, and compliance requirements unique to respiratory care. Many practices see a 15–25% increase in collections after switching to expert billing services.

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