73502

Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views

CPT code 73502 represents a diagnostic radiological examination of a single hip joint, which may include views of the pelvis if performed, specifically requiring two to three distinct projections or views. This imaging study is highly relevant in both acute and chronic orthopedic and general medical settings. The procedure is typically ordered to evaluate a variety of clinical conditions affecting the hip joint, such as acute trauma, including suspected hip fracture or dislocation, chronic pain, degenerative joint disease like osteoarthritis, inflammatory arthropathies, avascular necrosis, osseous tumors, and congenital or developmental dysplasia. The inclusion of the pelvis in the imaging protocol allows for a comparative assessment and helps identify associated pelvic ring fractures or other pathologies that might refer pain to the hip. During the examination, the patient is positioned on the radiographic table, and the radiologic technologist carefully aligns the X-ray tube and image receptor. The 2 to 3 views usually comprise a standard anteroposterior or AP view of the hip, and often the entire pelvis to assess symmetry and the contralateral joint, along with one or two lateral projections. These lateral projections may include a frog-leg lateral view for patients with good mobility, or a cross-table lateral view for trauma patients who cannot safely move their hip. The AP view provides excellent visualization of the femoral head, femoral neck, greater and lesser trochanters, and the acetabulum. The lateral view is crucial for assessing anterior or posterior displacement, identifying subtle femoral neck fractures, and evaluating the spherical nature of the femoral head. A board-certified radiologist subsequently interprets the captured images, meticulously assessing bone density, joint space narrowing, osteophyte formation, fracture lines, subchondral sclerosis or cysts, and any incidental soft tissue abnormalities. Strict adherence to radiation safety protocols, including the ALARA principle—As Low As Reasonably Achievable—and the use of proper shielding when it does not obscure the diagnostic area of interest, is consistently maintained throughout the entire procedure. Accurate documentation of the specific views obtained and the clinical rationale is essential for both medical continuity of care and compliant billing.

Clinical Indications

  • Acute hip pain following trauma or fall
  • Suspected hip fracture or dislocation
  • Chronic hip pain persisting despite conservative management
  • Evaluation of suspected or known osteoarthritis of the hip joint
  • Assessment of avascular necrosis of the femoral head
  • Preoperative planning for total hip arthroplasty
  • Postoperative follow-up of previously diagnosed hip conditions or prior hardware placement
  • Evaluation for suspected osseous tumors or metastatic disease
  • Assessment of congenital or developmental hip dysplasia

Procedure Steps

  1. Patient assessment, verification of the physician order, and confirmation of patient identity.
  2. Explanation of the procedure to the patient and screening for pregnancy if applicable.
  3. Patient preparation, requiring the removal of radiopaque objects, belts, and clothing over the pelvic and hip region.
  4. Positioning the patient supine on the radiographic table with alignment of the target hip to the image receptor.
  5. Internal rotation of the patient's lower limb (approximately 15 to 20 degrees) to place the femoral neck parallel to the image receptor for the AP view.
  6. Adjustment of the X-ray tube and centering of the central ray over the femoral neck.
  7. Acquisition of the AP radiograph, potentially including the entire pelvis if clinically indicated by the performing facility protocol.
  8. Repositioning the patient for the lateral view, such as a frog-leg lateral (flexing and abducting the hip) or a cross-table lateral for trauma patients unable to move the affected limb.
  9. Acquisition of the lateral radiograph.
  10. Review of the captured 2 to 3 images by the technologist to ensure diagnostic quality, adequate field of view, and proper exposure.
  11. Digital transmission of the images to the Picture Archiving and Communication System (PACS) for radiologist interpretation.
  12. Formal interpretation of the images and generation of a radiological report by a qualified physician.

Coding Guidelines

  • Report 73502 when exactly 2 or 3 views of a unilateral hip are obtained.
  • Do not report 73502 in conjunction with pelvic X-ray codes (e.g., 72170, 72190) unless a distinctly separate medical necessity exists, because the descriptor for 73502 explicitly includes 'with pelvis when performed'.
  • Append the appropriate laterality modifier (RT for Right side or LT for Left side) to specify which hip was examined.
  • If only 1 view of the hip is obtained, report 73501 instead of 73502.
  • If 4 or more views of a unilateral hip are obtained, report 73503 instead of 73502.
  • If imaging is performed bilaterally, do not report 73502 twice or append modifier 50. Instead, utilize the specific bilateral hip radiologic examination codes (73521, 73522, or 73523) based on the total number of views obtained.
  • Ensure documentation clearly states the number of views and the specific projections obtained to support the selection of 73502.

Associated ICD-10 Codes