For a free consultation, call +1-469-799-5556

Pulmonology Billing and Coding Services Built for Precision and Payouts

Accurate coding, clean claims, and fewer denials. our pulmonology RCM experts manage everything from PFTs to sleep studies, so you can focus on patient care while we maximize your reimbursements.

Why Pulmonology Billing Breaks Most RCM Teams

Pulmonology billing isn’t like general internal medicine. It’s more layered, more regulated, and more frequently denied. Many RCM teams simply aren’t equipped to handle the specific demands of this specialty, leading to lost revenue, compliance risks, and frustrated providers.

Bundling errors with spirometry, PFT, and oximetry codes.
Denials from incorrect coding of in-lab vs sleep studies.
Payment delays caused by incomplete bronchoscopy.
Modifier errors (25, 59) when billing E/M with same-day.
Missed payments due to delayed pre-authorizations.
Denials for missing documentation on oxygen therapy.
Lost revenue from underused or misapplied CCM & TCM.

At Vigilant Medical Group, we specialize in pulmonology billing so your claims go out right the first time.

Complex CPT Coding for Diagnostic Tests
Sleep Study Billing Errors
Incomplete Medical Documentation
Inaccurate Coding and Modifier Misuse
Prior Authorization Delays
Non-Compliance with LCD/NCD
Chronic Care Billing & Payer Rule Variations

Vigilant Pulmonology Billing Internal Audit

1. E/M Visit Denied

E/M with spirometry or other diagnostic testing billed same day without Modifier 25.

2. Claim Denied

Missing clinical time logs or COPD diagnosis when billing Medicare pulmonary rehab (G0424).

3. Flagged as Duplicate

Multiple sleep study claims submitted without clear titration or follow-up documentation.

4. Procedure Zeroed Out

Bronchoscopy codes (e.g., 31624, 31625) denied due to lack of modifier or incorrect bundling.

5. Improper Payments

TC/26 errors on imaging (e.g., chest X-rays, PFTs) causing incorrect reimbursement splits.

6. Audit Exposure

Missing time logs or consent forms for CCM or RPM services tied to chronic respiratory care.

7. Rental Rejection

CPAP or oxygen equipment billed under DME without supporting usage or compliance reports.

8. Non-covered Service

No proof of oxygen qualification (e.g., missing SpO2 levels or test documentation).

9. Underpayment

Incorrect place-of-service or billing discrepancies between inpatient and outpatient care.

Vigilant Pulmonology Billing Internal Audit

E/M Visit Denied

›

E/M + diagnostic testing billed same day without Modifier 25.

Claim Denied

›

Missing clinical time logs or COPD diagnosis for Medicare pulmonary rehab.

Flagged as Duplicate

›

Sleep study claims lack titration/follow-up documentation.

Procedure Zeroed Out

›

31624 + 31625 submitted without modifier strategy.

Improper Payments

›

TC/26 errors on imaging and PFTs.

Audit Exposure

›

Missing CCM time logs or consent forms.

Rental Rejection

›

Improper CPAP/DME billing without usage data.

Non-covered Service

›

Lack of oxygen qualification (SpO2, test result)

Underpayment

›

Site-of-service mismatch in inpatient vs. outpatient

We Cover Pulmonology Subspecialty Billing

Sleep Medicine

Accurate coding for sleep studies (in-lab and home), CPAP therapy, and DME management.

PFTs

xpert billing for spirometry, lung volume, and diffusion capacity with proper bundling and modifiers.

Interventional Pulmonology

Billing for bronchoscopies, biopsies, thoracentesis, and ablation procedures.

Chronic Respiratory

Specialized coding for COPD, asthma, and long-term oxygen therapy including time-based care codes.

Critical Care

Precise billing for inpatient consults, ventilation management, and ICU procedures.

Allergy & Immunology

Billing for pulmonary-related allergy testing, immunotherapy, and biologic drug.

Rehabilitation

Accurate claim submission for monitored exercise, education, and breathing therapy sessions.

Rare Lung Disease

Niche billing expertise for advanced therapies, genetics, and case management services.

Pulmonology RCM That Moves the Needle on Your Collections

At Vigilant Medical Group, we build an RCM engine that drives real, measurable results. By applying specialty-specific edits, accurate modifier logic, and proactive denial prevention, we help pulmonology practices reduce claim denials by up to 90% and accelerate payment cycles to under 18 days on average.

We go beyond the basics to plug revenue leaks most teams miss. From recovering up to $15,000/month in underbilled services to improving pre-auth turnaround. Our real-time dashboards give you a clear view into CPT performance, payer behavior, and reimbursement trends.

Vigilant Medical Group helps you boost collections by 30-35% and keeping your revenue cycle aligned with the way you deliver care. Let’s turn your billing challenges into measurable wins.

Denial Rate Reduction

0 %

Faster Time to Payment

0 Days

Clean Claim Rate

0 %

Underbilling Recovery

$ 0

Authorization Efficiency

0 %

Improve Collections

0 %

End-to-End Pulmonology Medial Billing Services

Charge Capture & Coding

We extract and validate charge data from EMRs, applying precise CPT, ICD-10, and modifier coding for procedures like spirometry, sleep studies, bronchoscopy, and chronic care services.

Insurance Verification & Prior Authorization

Our team confirms eligibility and handles prior auth requests for high-denial areas like sleep studies, oxygen therapy, and DME to minimizing delays and rework.

Claim Creation & Submission

We build clean claims with pulmonology-specific edits and submit them within 24 hours, ensuring compliance with Medicare and commercial payer rules.

Denial Management & Appeals

All rejections are reviewed within 48 hours, with structured appeals for common pulmonology denials like modifier misuse, insufficient documentation, or bundling issues.

Payment Posting

ERAs and EOBs are auto-posted, variances are flagged instantly, and underpayments are tracked by CPT, payer, and location—ensuring full reimbursement accuracy.

RCM Reporting & Insights

We deliver real-time dashboards to monitor CPT trends, denial sources, payer performance, and revenue per visit type, empowering decision-making and long-term growth.

Pulmonology Medical Coding Services

Coding in pulmonology is complex, combined with bundled services, evolving CPT rules, and tight documentation requirements. From pulmonary function tests to sleep studies, even a small oversight can cause denials, bundling errors, or compliance risk.

At Vigilant Medical Group, our certified coders specialize in pulmonology, applying precise codes based on diagnosis, service location, and payer guidelines including complex multi-service scenarios like PFT bundles (94726 + 94729).

We follow a proven 7-step coding process built specifically for pulmonology practices. By combining manual expertise with real-time coding validation, we help providers increase coding accuracy, reduce claim edits, and accelerate clean claim submission .

Schedule a Consultation

Services

Healthcare Type

Specialty

Name

Phone

Website

Message

By submitting this, I agree to the Terms & Conditions

Why Choose Vigilant

Pulmonology Billing and Coding Services

Our team is made up of certified coders, RCM analysts, and compliance experts trained specifically in pulmonary function testing, sleep medicine, interventional procedures, and chronic care billing. We build and manage a system that’s designed to reduce rework, boost first-pass acceptance, and recover underbilled revenue month after month.

Whether you’re a solo pulmonologist, a hospital-based provider, or managing a multi-location group, we tailor our workflow around your care model, EHR setup, and payer mix. Cleaner claims, faster payments, fewer denials, and full visibility into where your revenue stands.

Hear from Our Satisfied Clients

CMS Pulmonology Billing and Coding Guidelines

Explore CMS guidelines for pulmonology billing and coding. Covering PFTs, oxygen therapy, and sleep studies. Stay compliant, reduce denials, and ensure accurate reimbursement.

Co 24 Denial Code: Causes, Solutions, and Best Practices

CO 22 Denial Code: Reasons and How to Fix Coordination of Benefits Denials

Let’s build your Pulmonology billing around how you practice, not the other way around.

No templates, no shortcuts, just billing that fits your practice perfectly

Vigilant Billing MS simplifies medical billing to reduce denials and accelerate reimbursements. We empower healthcare providers to focus on what matters most—patient care and optimized revenue.

Company

Services

Reach Us

Email Support

info@vigilantbillingms.us

Let's Talk

Primary: +1-469-799-5556
Secondary: +1-945-994-8898
Fax: +1-469-983-0095

Map Directions

Building 1809 Possum Fire Trail, Mesquite TX 75181