Ask Dr. Z

I am being questioned about how the following report should be coded: "Using CT guidance a Jamshidi needle was placed in the left posterior iliac line. A 15 cc aspirate was obtained and handed to cytopathology technologist. A core was attempted to be obtained through the Jamshidi needle; however, despite multiple attempts all that was gained was clot. Core specimen was not obtained."  Should this be reported with code 38220 or 38221, with/without a modifier? Is there any difference between the physician and facility coding in a case like this? Also I am being asked in what cases would code 38220 be reported? He thought just an aspiration (38220) would never be performed. Thanks so much for your help!