Anesthesia - CRNA's

Any experienced anesthesia coders out there? Any from AZ? The CRNA performs a lumbar puncture 62270 in the ER. The CRNA also provides the anesthesia service 00635. 1) Does the 00653 bundle with the pro code 62270? 2) Is performing a lumbar puncture within the scope of practice for CRNA in a rural health setting?
3) A lumbar puncture is commonly performed in the ER yet our claim has been denied for "inconsistent with POS". Any thoughts as to why?

re: Anesthesia - CRNA's

Lumbar Puncture

A lumbar puncture may be performed for diagnostic or therapeutic purposes. Diagnostic lumbar puncture is a procedure which is done to remove a small amount of cerebrospinal fluid for laboratory testing, and is reported with CPT® code 62270. A therapeutic lumbar puncture is reported with CPT® code 62272. Fluoroscopy may or may not be required to assist with visualization of specific spinal anatomy for lumbar puncture needle placement. If fluoroscopy is utilized for lumbar puncture, fluoroscopic guidance should be additionally reported with CPT® code 76005.1

Check out this article: http://www.todayshospitalist.com/?b=articles_read&cnt=287

** Our Neurosurgeons perform this test. I don't believe a CRNA can perform this test, but I could be wrong.

re: Anesthesia - CRNA's

Always good to check the state scope of practice, as indicated in the answer above.