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TRICARE Policy Manual 6010.60-M, April 1, 2015
Chapter 7
Section 13.1
Pulmonary Services
Issue Date:  April 19, 1983
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
94002 - 94004, 94010 - 94799
Services provided for the diagnosis or treatment of conditions involving the lungs.
3.1  Pulmonary services including pulmonary services provided as part of a treatment program on an inpatient or outpatient basis are covered.
3.2  For an indication to be covered the efficacy of the pulmonary services must be proven.
Note:  Examples of proven indications are: cardiopulmonary or pulmonary rehabilitation for pre- and post-lung transplant patients when preauthorized by the appropriate preauthorizing authority as outlined in the Policy on heart-lung and lung transplantation; effective September 13, 1999, severe Chronic Obstructive Pulmonary Disease (COPD) on an inpatient basis; and moderate and severe COPD on an outpatient basis.
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