PCM · Pulmonology
PCM Qualifying Diagnoses
for Pulmonology.
12 ICD-10 codes qualify pulmonology patients for Principal Care Management (PCM).
Qualifying Codes
ICD-10 codes for pulmonology.
Asthma
3 codesModerate persistent asthma with (acute) exacerbation
Moderate persistent asthma with (acute) exacerbation
Severe persistent asthma, uncomplicated
SpO2 + respiratory rate monitoring; high-risk for exacerbation
Severe persistent asthma, uncomplicated
SpO2 + respiratory rate monitoring; high-risk for exacerbation
Severe persistent asthma with (acute) exacerbation
Severe persistent asthma with (acute) exacerbation
Cancer
1 codeMalignant neoplasm of lung, unspecified
SpO2 monitoring during treatment
Malignant neoplasm of lung, unspecified
SpO2 monitoring during treatment
COPD
3 codesCOPD with (acute) lower respiratory infection
COPD with (acute) lower respiratory infection
COPD with (acute) exacerbation
SpO2 monitoring critical; exacerbation history drives RPM enrollment
COPD with (acute) exacerbation
SpO2 monitoring critical; exacerbation history drives RPM enrollment
COPD, unspecified
COPD, unspecified
Interstitial Lung Disease
1 codePulmonary fibrosis, unspecified
SpO2 trending critical for disease progression monitoring
Pulmonary fibrosis, unspecified
SpO2 trending critical for disease progression monitoring
Respiratory Failure
2 codesChronic respiratory failure, unspecified
Chronic respiratory failure, unspecified
Chronic respiratory failure with hypoxia
Chronic respiratory failure with hypoxia
Sleep Disorders
1 codeObstructive sleep apnea
Most common sleep disorder for RPM; CPAP compliance monitoring
Obstructive sleep apnea
Most common sleep disorder for RPM; CPAP compliance monitoring
Venous Thromboembolism
1 codeOther pulmonary embolism without acute cor pulmonale
Other pulmonary embolism without acute cor pulmonale
Clinical Context
Why pulmonology practices benefit from PCM.
Pulmonology practices can leverage PCM to improve patient outcomes through structured care management, generating $97–$220+ per patient per month in Medicare reimbursement while reducing avoidable hospitalizations.
FAQ
Common questions.
What ICD-10 codes qualify pulmonology patients for PCM?
There are 12 ICD-10 codes that qualify pulmonology patients for Principal Care Management (PCM). These include codes across 7 diagnosis categories: Asthma, Cancer, COPD, Interstitial Lung Disease, Respiratory Failure, Sleep Disorders, Venous Thromboembolism.
How does CCN Health support pulmonology practices with PCM?
CCN Health provides turnkey PCM services for pulmonology practices — including patient eligibility identification, enrollment documentation, device provisioning, clinical monitoring, and full Medicare billing support. Most practices are fully operational within 1 week.
What is the revenue potential for PCM in pulmonology?
PCM generates $68–149 per patient per month in Medicare reimbursement. Pulmonology practices with a high prevalence of qualifying conditions can scale rapidly, especially when PCM is stacked with other eligible programs like RPM and BHI.