TRICARE Policy Manual 6010.60-M, April 1, 2015 Medicine Chapter 7 Section 13.1 Pulmonary Services Issue Date: April 19, 1983 Authority: 32 CFR 199.4(b)(2)(xviii) Copyright: CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Revision: 1.0 CPT PROCEDURE CODEs94002 - 94004, 94010 - 94799 2.0 DESCRIPTIONServices provided for the diagnosis or treatment of conditions involving the lungs. 3.0 POLICY3.1 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. - END -