X038 – Pelvis and/or hip(s) - three or more views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A diagnostic radiology service for the examination of the pelvis and/or hip(s) that requires three or more views. The Schedule of Benefits provides examples such as 'pelvis and sacro-iliac joints, or AP both hips plus lateral each hip'. This service is comprised of a technical component (H fee) and a professional component (P fee), which are claimed separately. See related codes X036 and X037 for examinations with fewer views. (:)
When to Use
- Use X038 when the examination requires three or more distinct views, such as an AP pelvis combined with lateral views of both hips.
- Use X038 for complex pelvic imaging including sacro-iliac joints where the total view count meets the three-view threshold, distinguishing it from the limited views covered by X036 or X037.
Common Pitfalls
- Failing to split the claim into the technical component (X038B) and the professional component (X038C) will result in a rejection or incorrect payment.
- Billing X038 when only two views were performed is a common audit trigger; ensure the requisition and report explicitly confirm the three-view requirement was met.
Billing Tips
- Always verify the total view count against the Schedule of Benefits examples before selecting X038 over X036 or X037 to avoid downcoding during audits.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
e.g. pelvis and sacro-iliac joints, or AP both hips plus lateral each hip
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.