So I work for a family practice facility and one of our practitioners has started doing injections. I am so confused on what the different between a 20551 and 20550 are? Here is an example of one of her chart notes.

I think that I am only going to bill 20550 x1 since all 6 injections were all in the same area, correct? Or is this a 20551 x1?

Joint/Spine Injection:
Injection # 1
After discussion of the risks and benefits, the patient elected to proceed with the ligament injections into 6 sites – the bilateral IL ligaments and the supraspinous ligaments of L-2, L-3, L-4, and L-5. Informed consent was obtained. Confirmed that the patient does not have history of prior adverse reactions, active infections, or relevant allergies. There was no effusion, erythema, or warmth, and the skin was clear.
The skin was prepped in a sterile fashion with Chloraprep. Local anesthetic was introduced into the area of the injection site using 1% lidocaine/8.4% sodium bicarbonate 10:1 mixture.
Each of the IL sites were injected with a solution of 10cc lidocaine 1% w. sodium bicarb 8.4%. In total, the supraspinous ligaments were injected with 10cc. Total volume 30cc
Patient demonstrated that they were stable before being allowed to leave the facility. The patient tolerated the procedure without complication. The patient will call immediately with any signs of infection, fever or allergic reaction. Patient instructed to keep area clean, dry and covered, avoid anti-inflammatories (e.g. Advil, Aleve, Ibuprofen), also avoid use of ice, apply heat to injection site intermittently 24-48 hours.
The patient to return as instructed.