Skull X-ray (complete)

What it is

The skull is a curved box, so a single flat picture of it overlaps itself. A complete series works around that by taking the head from several fixed angles — front, back, each side, and angled projections that throw the facial bones and sinuses clear of the base of the skull. This code covers a series of more than four such views. What it images is bone: the vault, the facial bones, the nasal structures, and the air spaces. It says nothing directly about the brain, bleeding, or swelling, which is the reason a CT scan is ordered instead when those are the concern.

Why it is done

• To assess the shape of an infant's head and the seams between the skull bones when the head is growing unusually
• To look for a foreign metal object before an MRI, because metal in the head can move or heat in a magnetic field
• To evaluate the bones themselves for a suspected fracture, a bone tumor, or a bone infection where a CT is not being done
• To follow a known condition affecting the skull bones over time

What to expect

The patient sits in a chair or lies on the table, and the technologist moves the head into each position — chin tucked, head turned, sometimes tilted back — and holds it still with foam pads or a strap. Between six and a dozen exposures is not unusual for a complete series, and the appointment typically runs ten to twenty minutes. There is nothing to feel. For young children a parent may be asked to help with positioning and given a lead apron. Because the skull bones overlap heavily, the radiologist is comparing left against right as much as reading any single image.

Questions worth asking

• If a head CT is also planned, is the x-ray series still needed, or would one study answer the question?
• Is this being read by a radiologist on staff or by an outside teleradiology group that bills separately?
• For a child, does this clinic have a pediatric imaging protocol, and is it priced differently from the adult series?
• Can I get an itemized estimate that shows the technical charge and the reading charge as separate lines before the appointment?