Pulmonology EHR and AI Medical Billing Software

Pulmonology combines clinic visits, lung function testing and long-term therapy. XEHR keeps tests, prescriptions and notes in one record.

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Chart · Office visit

Lastname, Firstname M. Sample patient · DOB 01/01/1980 · Commercial

Eligible

BP128/82

HR72

BMI26.4

Temp98.6

Progress noteAI Scribe draft

Short of breath on stairs; using inhaler daily.

J44.9 COPD, unspecified

ReviewSign note

Diagnosis carried to the claimJ44.9

THE HARD PARTS

What makes pulmonology billing hard

Testing with its own billing rules

Lung function tests and their interpretation are billed separately from the visit, and each needs supporting documentation.

Biologics and specialty inhalers

Many therapies need prior authorization with test results and prior treatments attached.

Oxygen and equipment paperwork

Home oxygen and equipment need qualifying results and signed documentation, or the supplier cannot bill.

WHERE THE WORK HAPPENS

How pulmonology care is delivered and billed

Pulmonology combines office visits, pulmonary function testing, sleep studies and procedures such as bronchoscopy, often alongside critical care in the hospital. Office visits and test interpretations are billed on the professional claim; bronchoscopy usually happens in a hospital or surgery center, where the facility bills its own claim. Home oxygen and device orders add documentation that suppliers and payers audit.

What payers check on pulmonology claims

Home oxygen coverage requires documented qualifying oxygen measurements taken under the conditions payers define.
Pulmonary function tests are billed by test, and the interpretation must be documented by the physician.
Biologic therapies for severe asthma require prior authorization with documented eosinophil counts or other qualifying results.
Bronchoscopy done in a hospital or surgery center carries a facility place of service on the professional claim.
Follow-up of lung nodules is driven by documented size and risk, which payers use to judge imaging frequency.

Common pulmonology diagnoses ICD-10-CM

J44.1	Chronic obstructive pulmonary disease with (acute) exacerbation
J45.40	Moderate persistent asthma, uncomplicated
J84.10	Pulmonary fibrosis, unspecified
R91.1	Solitary pulmonary nodule
G47.33	Obstructive sleep apnea (adult) (pediatric)
J96.11	Chronic respiratory failure with hypoxia

Examples only. The provider chooses the code that matches the documented diagnosis, and XEHR checks it against the note and the payer's rules before the claim goes out.

A VISIT ON XEHR

A pulmonology visit, start to payment

1
Test before the visit

Pulmonary function results and imaging are in the chart and compared with earlier studies.
2
Document the decision

The note records symptoms, test results and the plan, including oxygen or device needs with the measurements that support them.
3
Order what the patient needs

Inhalers, biologics, oxygen and devices are ordered with the documentation the supplier and payer will ask for.
4
Bill test and visit

Test interpretations and the office visit are billed on one checked claim, with the right part of each test.

How XEHR helps

From the pulmonology visit to the payment

Tests documented with the visitResults and interpretations sit in the chart next to the note.
Prior authorizations from the chartHistory and results are pulled into the request for staff review.
Orders with supporting recordsEquipment orders carry the documentation suppliers need.
AI that waits for youThe AI drafts notes and prepares claims; your providers sign and your billers approve.

Claim · CMS-1500

Sample claimLastname, Firstname M. · DOS 03/04/2026

Scrub passed

Scrubbed
Submitted
Accepted
Paid

Service	Dx	Units	Charge
Office visit	E11.9	1	145.00
A1c test	E11.9	1	28.00
Total			173.00

ERA postedPayment applied, no re-keying

Agentic AI for pulmonology

AI medical billing for pulmonology practices

XEHR is an agentic EHR: AI agents do the administrative work around every pulmonology visit, and your team approves what matters. How agentic AI works

Before the claim leaves

The claim-check agent looks for

Home oxygen coverage requires documented qualifying oxygen measurements taken under the conditions payers define.
Pulmonary function tests are billed by test, and the interpretation must be documented by the physician.
Biologic therapies for severe asthma require prior authorization with documented eosinophil counts or other qualifying results.
Bronchoscopy done in a hospital or surgery center carries a facility place of service on the professional claim.

Around the visit

Agents run on their own

Coverage checked before each pulmonology visit
The visit note drafted for the provider to sign
Insurance payments matched and posted
Open claims tracked, denials read and appeals drafted

People decide

Your team stays in charge

Providers sign every note
Billers approve every claim and appeal
Staff submit prior authorizations
Any check can be overridden, with a reason

BUYER'S GUIDE

Questions to ask before you choose a pulmonology EHR

Ask every vendor, including us. The answers show whether a system was built for pulmonology work or only adapted to it.

Ask us on a demo

Are pulmonary function results trended against earlier studies?
Does an oxygen order carry the qualifying measurements and conditions the supplier needs?
Which biologics are flagged for prior authorization with the lab values attached?
Can test interpretations and the office visit be billed together on one claim?
Is lung nodule follow-up tracked so the next scan is not missed?

QUESTIONS

Pulmonology practices ask us

Does XEHR support prior authorization for biologics?

Yes. The request is prepared from the chart and tracked through approval.

Can XEHR document lung function testing?

Yes. Results and interpretation are recorded in the chart and carried to the claim.

Does XEHR document home oxygen qualification?

Yes. Qualifying measurements and the conditions they were taken in are recorded with the order, as suppliers and payers require.

Can pulmonologists bill pulmonary function test interpretations?

Yes. Each test and its interpretation are documented and billed, with the professional and technical parts kept straight.

Does XEHR support pulmonologists who also cover the ICU?

Yes. Critical care and hospital visits are billed from the same record as the clinic.

Can XEHR order sleep studies for pulmonary patients?

Yes. Studies are ordered with the documentation payers require.

How much does XEHR cost for a pulmonology practice?

Pricing is published: $189 per provider per month for the Clinical plan, $449 per provider per month for the Practice Suite with billing, or 2.5% of collections for RCM as a Service. Month-to-month, with a BAA on every plan. See pricing.

How long does it take a pulmonology practice to go live?

Small practices are usually live in 2 to 4 weeks, including setup, data migration and training. We agree the plan with you before you sign.

Related specialties

See all specialties

See XEHR set up for pulmonology

A 30-minute walkthrough on a live test environment, with your specialty's templates and billing.

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