Facial Bones X-ray (1 to 2 views)

What it is

The face is built from a set of thin, hollow, interlocking bones — the cheekbones, the nose, the upper and lower jaw, the walls around the sinuses. Plain radiography of this region uses a handful of standard projections, each angled to throw one part of that stack clear of the rest. The "<3" in the title is the whole distinction being made by this code: it is the study done with fewer than three views. Radiography codes for many body parts are tiered by how many projections were taken, because each additional view is extra positioning, extra exposure, and extra film for the radiologist to read. The clinical study is the same kind of study; the count is what sets the code and the price.

Why it is done

• To check for a fracture of the cheekbone, nose, or jaw after a blow to the face
• To look for a foreign body lodged in the soft tissue or bone of the face
• To answer a narrow question where one or two projections suffice, without committing to a full series

What to expect

No preparation. Jewelry, glasses, dentures, and hairpins come off, since metal blocks x-rays and creates shadows that can hide a fracture. The technologist positions your head against the plate — the angle varies by which bones are in question — and asks you to hold still and hold your breath for a moment. Each exposure lasts a fraction of a second. The visit takes a few minutes. It does not hurt, though positioning an injured face can. MedlinePlus notes that CT has largely displaced plain films for head and facial injury, because it shows the thin bones and the soft tissue together; if the x-ray is equivocal or the injury looks significant, a CT often follows.

Questions worth asking

• How many views were actually taken? This code is the under-three version, and three or more is a separate, higher-priced code.
• If the study is repeated because a view did not come out, am I charged for the repeat?
• Is the charge split into a technical fee for the images and a professional fee for the read, and are both providers in network?
• If a CT of the face is ordered after this, does my plan cover both studies done on the same day?