Pelvis X-ray (complete, 4 or more views)

What it is

The pelvis is a ring made of the two hip bones and the sacrum at the base of the spine. A single front-to-back film of it is the usual starting point, but this code describes the complete study: more than three images, taken with the X-ray beam angled up and down and the patient turned, so the front arch, the back joints where the sacrum meets the hip bones, and the sockets of both hips are each seen without other bone lying on top of them. Because the pelvis is a ring, force strong enough to break it in one place tends to break or separate it in another, and the additional views are what make the second injury visible.

Why it is done

• To look for pelvic fractures after a fall, a crush injury, or a high-energy accident
• To examine the sacroiliac joints, which can be involved in inflammatory arthritis
• To look at bone texture and shape in conditions that affect the skeleton broadly
• To follow up a known pelvic injury or surgical repair over time

What to expect

No preparation is needed beyond removing metal and changing into a gown. Most of the exam is spent being positioned: a technologist will roll the patient partly onto one side, then the other, or tilt the beam, taking one exposure at a time and asking for stillness. Lying flat and being moved can be painful with a fresh injury, and staff will usually work around that with supports and by limiting how far they turn the patient. The imaging itself is painless and takes a few minutes in total. A radiologist interprets the series and sends a report; the technologist will not read the films.

Questions worth asking

• How many views were actually taken? The complete study and a limited one-or-two-view study are different codes at different prices.
• If this is a follow-up on a known fracture, could a limited series answer the question instead of a repeat complete one?
• Was a hip X-ray billed on the same day as well, and does its coverage overlap with this one?
• If the images were repeated because the first set was unclear, is the repeat charged again?