Ask Dr. Z

Can you please help me on how to code this? I'm going back and forth on 20611 vs. 20551, or using both with a modifier on 20551. This was all done percutaneously under US guidance. 

"BARBOTAGE WITH 1% LIDOCAINE WAS PERFORMED AND ASPIRATION OF CALCIFIC CRYSTALS FROM THE DEPOSIT WAS NOTED. THIS PROCEDURE WAS REPEATED SEVERAL TIMES WITH A MIXTURE OF 1% LIDOCAINE AND STERILE SALINE UNTIL VISIBLE CALCIFIC DEBRIS WAS NO LONGER ASPIRATED INTO THE SYRINGE. AT THIS POINT, THE BURSAL-SURFACE OF THE TENDON IN THE REGION OF THE CALCIFIC DEPOSITION WAS FENESTRATED. FINALLY, THE NEEDLE WAS REPOSITIONED INTO THE SUBACROMIAL/SUBDELTOID BURSA AND THERAPEUTIC INJECTION WAS PERFORMED WITH A 3 ML MIXTURE OF 1 ML OF DEPO-MEDROL AND 2 ML 0.5% SENSORCAINE."