MedCare Billing Solutions specializes in pulmonology medical billing for respiratory medicine, sleep medicine, and critical care practices. Our AAPC-certified coders know every PFT code, bronchoscopy bundling rule, and sleep study billing requirement — so you collect every dollar you've earned.
Respiratory and sleep medicine procedures involve intricate bundling rules, supervision requirements, and payer-specific policies. Pulmonologists who use general billing staff routinely leave 12–18% of their revenue uncollected due to:
The average pulmonology practice with 3 physicians leaves $140,000–$280,000/year in uncollected revenue due to PFT bundling errors, denied sleep studies, and missed DME authorizations. MedCare's specialists close that gap.
Our coders are trained on all respiratory procedure codes, including the most complex bronchoscopy and sleep medicine codes.
| CPT Code | Procedure | Common Billing Issue |
|---|---|---|
| 94010 | Spirometry (FVC, FEV1, FEV1/FVC) | Incorrectly bundled with 94060; missing -TC/-26 modifier |
| 94060 | Spirometry with bronchodilator response | Billed separately from pre/post components when combined |
| 94726 | Plethysmography for lung volumes | Missing supervision documentation; unbundling errors |
| 94729 | Diffusion capacity (DLCO) | Billing standalone when bundled with full PFT series |
| 31622–31646 | Bronchoscopy series | Incorrect add-on code use; missing biopsy documentation |
| 95800–95811 | Sleep study codes (home/facility) | Wrong code for attended vs. unattended; missing titration notes |
| 99291–99292 | Critical care services | Time not documented; incorrect bundling with procedures |
| 94640 | Nebulizer treatment | Billing for each treatment without medical necessity documentation |
Real-time eligibility verification and prior authorization management for sleep studies, CPAP/BiPAP, home oxygen, and advanced pulmonary procedures before every appointment.
AAPC-certified coders with pulmonology subspecialty expertise. We handle PFT labs, bronchoscopy suites, sleep centers, and outpatient respiratory offices.
Electronic claim submission within 24 hours of charge entry. AI-powered scrubbing against payer-specific pulmonary code edits before every submission.
Specialized pulmonology denial appeal team. We fight every medical necessity denial, bundling dispute, and sleep study authorization until you're paid.
Aggressive accounts receivable management with payer-specific follow-up workflows. We keep your 90+ day AR below 10% — industry average is 28%.
Full pulmonologist credentialing and re-credentialing with Medicare, Medicaid, and all major commercial payers. Prevent revenue gaps from enrollment delays.
Get a free, confidential pulmonology billing audit. We'll show you exactly where your practice is losing money and what it will take to recover it.