Medical Billing · Nationwide
Pediatric Allergy, Pulmonology & Cystic Fibrosis Medical Billing Services
Pediatric spirometry and plethysmography, pre/post bronchodilator responsiveness, quantitative sweat chloride iontophoresis, high-cost CFTR modulator prior-authorizations, and aerosolized antibiotic infusions.
Aethera Healthcare Solutions provides full-service medical billing and revenue cycle management to pediatric pulmonologists, pediatric asthma & allergy centers, and accredited cystic fibrosis care clinics across the United States. We handle coding, claims, payment posting, denial management, and A/R follow-up end to end — so your team can stay focused on patient care while your revenue cycle runs cleanly.
Typical pediatric allergy, pulmonology & cystic fibrosis CPT range we work: 94010, 94060, 94726, 82435, 94640, 95004, 94621, J7605, J7626, J7613, 99214.
Why pediatric allergy, pulmonology & cystic fibrosis billing leaks revenue
PFT component unbundling rejections: Commercial payers denying pre/post bronchodilator spirometry (94060) when billed alongside routine baseline spirometry (94010) or diagnostic plethysmography (94726)
Sweat chloride test (82435) medical necessity denials: Rejection of pilocarpine iontophoresis diagnostic sweat testing due to missing positive newborn screening (IRT) documentation or failure to thrive ICD-10 links
CFTR modulator (Trikafta/Kalydeco) prior authorization clawbacks: Commercial payers rejecting high-cost CFTR triple combination therapy due to rigid F508del mutation lab verification and adherence telemetry documentation
Inhalation treatment administration bundling: Downcoding of multi-drug aerosolized inhalation treatments (CPT 94640) administered in-office during acute pediatric asthma exacerbations
How Aethera fixes it
Specialty-trained coders (CPC/CCS) code to the documentation
First-pass claim scrubbing against payer and NCCI edits
Proactive denial prevention and 72-hour denial work
Relentless A/R follow-up to drive days-in-A/R down
Eligibility and prior-auth verification before service
Transparent, real-time reporting in the provider portal
Free tools for your billing team
Use these any time — no login required.
Pediatric Allergy, Pulmonology & Cystic Fibrosis billing FAQ
Can pre- and post-bronchodilator spirometry (CPT 94060) be billed with baseline spirometry (CPT 94010)?
No. CPT 94060 (bronchodilator responsiveness evaluation) encompasses both the pre-bronchodilator baseline spirometry and the post-bronchodilator repeat testing. Billed together on the same date of service, CPT 94010 is an NCCI column 2 code to 94060 and cannot be unbundled with any modifier.
What documentation is required to overturn CFTR modulator prior authorization rejections?
Appeals must include certified CLIA molecular genetic sequencing demonstrating at least one F508del mutation (or FDA-approved responsive CFTR variant), baseline percent predicted FEV1 spirometry curves, comprehensive liver function panels, sweat chloride quantitative baseline concentration (>= 60 mmol/L), and an attestation of CF Foundation accredited center multidisciplinary oversight.