Understanding Pulmonology Data on Sunlight Ledger

What Pulmonologists Do

Pulmonologists specialize in diseases of the lungs and respiratory system. They diagnose and treat conditions including chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis, pulmonary hypertension, lung cancer, and respiratory infections. Many pulmonologists also specialize in critical care medicine and manage patients in intensive care units. Sleep medicine is a closely related subspecialty, and many pulmonologists are board-certified in both.

Common Procedures in Medicare Data

  • Bronchoscopy — Scope examination of the airways, used for diagnosis and tissue sampling
  • Pulmonary function testing — Spirometry and lung volume measurement to assess respiratory capacity
  • Endobronchial ultrasound (EBUS) — Bronchoscopy with ultrasound guidance for lymph node biopsies
  • Sleep study interpretation — Polysomnography review for sleep apnea and other sleep disorders
  • Chest tube placement — For pneumothorax or pleural effusion
  • Thoracentesis — Drainage of fluid from around the lung
  • Office visits — Management of chronic respiratory conditions like COPD and asthma

What Normal Volume Looks Like

Pulmonologists who focus on outpatient chronic disease management will bill primarily for office visits and pulmonary function tests. Those with active bronchoscopy practices will have higher procedure counts. Intensivists who work primarily in the ICU may bill for critical care time codes rather than discrete procedures.

Pharma Payments in Pulmonology

Pharmaceutical companies marketing inhaled medications for COPD and asthma — including long-acting bronchodilators and inhaled corticosteroids — are significant payment sources in pulmonology. Companies marketing drugs for pulmonary fibrosis and pulmonary hypertension, which are expensive specialty medications, also engage pulmonologists in consulting and speaking relationships.

Questions to Ask Your Pulmonologist

  • Do you have financial relationships with the makers of the inhalers or other medications you are prescribing?
  • Is my current inhaler regimen based on current GOLD or GINA guidelines for my disease severity?
  • If bronchoscopy is recommended: what are you looking for, and what are the alternatives to an invasive procedure?
Data Disclaimer — Data sourced from the Centers for Medicare & Medicaid Services (CMS): National Plan and Provider Enumeration System (NPPES), Open Payments program, Medicare Provider Utilization and Payment Data, and Provider Enrollment & Certification data (PECOS). Published under the Freedom of Information Act (FOIA). This website is not affiliated with, endorsed by, or authorized by CMS, HHS, or the U.S. Government. Data may contain errors as reported to CMS by providers and reporting entities. Industry payment disclosure alone establishes neither wrongdoing nor legality. Medicare data reflects only patients aged 65+ or those with qualifying disabilities. For corrections, contact CMS directly. This information does not constitute medical advice and should not be used as the sole basis for choosing a healthcare provider. Procedure descriptions use plain language and do not reference CPT® codes, which are copyrighted by the American Medical Association. Full methodology → · Report a data error → · Privacy policy →