Neurology & Pain Management Coding Alert

Version 7.2 of the national Correct Coding Edits (CCI), which became effective July 1, contains many edits that affect codes and code combinations used by neurology practices.
Puncture Codes Now Include Injections  
Two spinal puncture codes bundle spinal injection codes, so the procedures may no longer be separately billed if performed at the same anatomical site:   
 
Code 62270 (spinal puncture, lumbar, diagnostic) includes 62311 (injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; lumbar, sacral [caudal]) and 64483 (injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level).
 
Code 62272 (spinal puncture, therapeutic, for drainage of spinal fluid [by needle or other catheter]) also includes 62310 (injection, single [not via indwelling catheter], not including neurolytic substances, with or without contrast [for either localization or epidurography], of diagnostic or therapeutic substance[s] [including anesthetic, antispasmodic, opioid, steroid, other solution], epidural or subarachnoid; cervical or thoracic), 62311, 64479 (injection, anesthetic agent and/or steroid, transforaminal epidural; cervical or thoracic, single level) and 64483.  
The following injection code has edits:
62273 (injection, epidural, of blood or clot patch) bundles seven additional codes: 62284 (injection procedure for myelography and/or computerized axial tomography, spinal [other than C1-C2 and posterior fossa]), 62310, 62311, injection and catheter placement for continuous infusion or intermittent bolus codes 62318 (... cervical or thoracic) and 62319 (... lumbar, sacral [caudal]), 64479 and 64483.   
Each of the above edits includes a CCI edit indicator of "1," meaning modifier -59 (distinct procedural service) may be used to break the bundle if the "comprehensive" procedure (i.e., 62270, 62272 or 62273) and the "component" procedure (i.e., 62311) are performed at different anatomical sites.
 
Always append the appropriate modifier to the component code. For example, the neurologist performs a lumbar spinal puncture and injects an anesthetic agent at a different lumbar level. In this case, 62270 and 64483 may be reported separately, with modifier -59 appended to the latter. Documentation should clearly note that the puncture and injection occurred at distinct lumbar levels, e.g., at the L1-L2 and L2-L3 interspaces.
Biofeedback Training Adds Procedures  
Biofeedback training (90901, ... by any modality) bundles five new procedures: EMG studies 51784 (... of anal or urethral sphincter, other than needle, any technique) and 51785 (... of anal or urethral sphincter, any technique), as well as 51795 (voiding pressure studies [VP]; bladder voiding pressure, any technique), 64550 (application of surface [transcutaneous] neurostimulator) and 91122 (anorectal manometry). 
Injection and Others Are Now Components  
Several codes have been newly designated as components of "more extensive" procedures.
 
As mentioned, EMG studies 51784 and 51785 are now included in [...]