I'm so glad you are an xray tech, since at our facility, we are getting a discrepancy between people in regards to bilat hip xrays. Some techs state AP and lateral views of the right and AP and lateral views of the left is a 2 view study (73521) while others are stating it is 4 views (73522). Am I correct that it truly is 4 views?
Hip X-rays are taken depending on the exam protocol, why the exam is being ordered, and the patient's age. Hips should be coded unilaterally on adults. Here are my rad tech/coding notes:
Hip Series
The hip series evaluates the hip joint and proximal femur. The image shows the entire joint. This procedure generates images that provide detailed information about joint shape, size, alignment, cartilage thickness, and other important features for proper diagnosis. This imaging series is typically used for trauma, OA pain, pre-surgical planning, or monitoring post-surgical progress. Specific protocols include the AP pelvis so that physicians can compare both hips.
Report Example
Order CPT: 73502
Order Exam: Hip 2 or 3 Views w/wo Pelvis - R
HEADER: AP PELVIS; AP AND FROG-LEG LATERAL VIEWS OF THE RIGHT HIP
Order CPT: 73503
Order Exam: Hip 4 Views w/wo Pelvis - R
HEADER: AP PELVIS; FALSE PROFILE, DUNN, AND FROG-LEG VIEWS OF THE RIGHT HIP
Order CPT: 73523
Order Exam: Hip 5 views w/wo Pelvis - Bilat
HEADER: AP PELVIS WITH AP AND CROSS-TABLE LATERAL VIEWS OF BOTH HIPS
Views
Hip AP View
Hip Lateral View(Frog Leg)(Rolled Lateral)(Modified Cleaves Method)
Hip Lateral Cross-table View (Danelius-Miller Method)
Hip Axiolateral View (Clements-Nakayama Method)
Hip AP Oblique View (False Profile)
Hip AP Oblique View (Dunn)
Hip AP Oblique View (Dunn 40-40)
Hip AP Oblique View (Dunn 20-80)
Hip AP Oblique View (Friedman Method)
Hip PA Oblique View (Hsieh Method)
Hip PA Oblique View (Lilienfeld Method)
Hip PA Axial Oblique View (Teufel Method)
Hip AP Abduction-internal Rotation View (AIR view) (Von Rosen)
Pelvis AP View
This image of the entire pelvis demonstrates the head, neck, and trochanters of the proximal femurs. The patient is supine with toes inverted.
Hip AP View
For a front-to-back view, the patient is supine with the leg internally rotated, putting the neck of the femur in profile. This view also visualizes the femoral head, the ilium, pubic bones, pubic symphysis, hip joint, and greater trochanter in profile.
Hip Lateral View (Frog Leg)(Rolled Lateral)(Modified Cleaves Method)
A projection with the patient's hips externally rotated this view can only be performed on a non-trauma patient. This lateral view of the hip shows the femoral neck, acetabular rim, and the lesser trochanter of the femur.
Hip Lateral Cross-table View (Danelius-Miller Method)
This lateral projection is performed on unilateral hip trauma to visualize the femur's neck without movement of the affected limb.
Hip Axiolateral View (Clements-Nakayama Method)
The lateral projection shows the neck of the femur without movement of either limb for bilateral hip or femur trauma.
Hip AP Oblique View (False Profile)
This view examines the femoral anteversion. Orthopedic surgeons perform this view to aid in and diagnose femoral-acetabular impingement. The projection is an oblique lateral radiograph showing the relationship between the hip joint, acetabulum, and femoral head. It can be obtained in different degrees of obliquity.
Hip AP Oblique View (Dunn)
This view examines the femoral anteversion.
Hip AP Oblique View (Dunn 40-40)
This view examines the femoral anteversion.
Hip AP Oblique View (Dunn 40-80)
This view examines the femoral anteversion.
Hip AP Oblique View (Friedman Method)
An orthopedic view to evaluate the femoral head, neck, trochanters, and femoral shaft.
Hip PA Oblique View (Hsieh Method)
An orthopedic view demonstrates posterior dislocations of the femoral head and shows the ilium, hip joint, and proximal femur.
Hip PA Oblique View (Lilienfeld Method)
An orthopedic view shows the hip joint, femoral head, acetabulum, and ileum.