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The 20610 cpt code description states without ultrasound guidance. When ultrasound is used with permanent recording and a separate interpretation report, CPT 20611 is the correct code

Discard the vial

(PubMed) Blanchard G, Kerre S, Walker A, et al

Nutrient treatment is used to correct the underlying biochemical contributors so that medication decisions can later be made from a stronger and more stable foundation

Response: While we understand commenters' concerns, we believe that the RUC-recommended work RVU and direct PE inputs for CPT code of 33340 are appropriate choices for valuation