How To Use CPT Code 75563

CPT 75563 describes the use of cardiac magnetic resonance imaging (MRI) to assess the structure and function of the heart under stress. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 75563?

CPT 75563 is used to describe the cardiac MRI procedure that evaluates the morphology and function of the heart without contrast material, followed by the use of contrast material and further sequences, specifically for stress imaging. This code is used when the provider first obtains images of the heart without contrast, and then administers a contrast agent to enhance visualization of the area. The stress imaging component involves the injection of medicine to increase blood flow and/or heart rate, allowing the physician to assess the coronary arteries for narrowing or blockage.

2. Official Description

The official description of CPT code 75563 is: ‘Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging.’

3. Procedure

1. The patient is prepared for the MRI procedure by removing any metal objects that may interfere with the magnets.
2. The patient lies down on a narrow table that slides into the MRI device.
3. The MRI machine takes multiple cross-sectional images (slices) of the heart to assess its structure and function.
4. Initially, images are obtained without the use of contrast material.
5. A contrast agent, such as gadolinium, is then administered to enhance visualization of the area.
6. For stress imaging, the physician may inject medicine, such as dobutamine, to increase blood flow and/or heart rate.
7. The physician evaluates the coronary arteries for any narrowing or blockage.

4. Qualifying circumstances

CPT 75563 is used for patients who require cardiac MRI to assess the morphology and function of their heart under stress. This procedure is typically performed on patients with suspected coronary artery disease or other cardiac conditions. The use of contrast material and stress imaging is necessary to obtain a comprehensive evaluation of the heart’s structure and function.

5. When to use CPT code 75563

CPT code 75563 should be used when the provider performs a cardiac MRI without contrast material, followed by the administration of contrast material and further sequences for stress imaging. This code is appropriate when the stress imaging component is necessary to evaluate the coronary arteries for narrowing or blockage. It is important to ensure that the documentation supports the use of both contrast material and stress imaging in order to report CPT 75563.

6. Documentation requirements

To support a claim for CPT 75563, the provider must document the following information:

• Indication for the cardiac MRI procedure
• Documentation of the MRI performed without contrast material
• Administration of contrast material and further sequences
• Stress imaging component, including the medication used and the evaluation of the coronary arteries
• Date and time of the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 75563, it is important to ensure that the documentation supports the use of both contrast material and stress imaging. If reporting only the physician’s interpretation for the radiology service, append modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. However, payer policies may exempt hospitals from appending modifier TC. When reporting a global service in which one provider renders both the professional and technical components, do not append a professional or technical modifier to the radiology code.

8. Historical information

CPT 75563 was added to the Current Procedural Terminology system on January 1, 2008. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes a cardiac MRI without contrast material, followed by the administration of contrast material and further sequences for stress imaging to evaluate the coronary arteries for narrowing or blockage.
2. During a cardiac MRI procedure, the provider obtains images of the heart without contrast, administers a contrast agent, and performs stress imaging to assess the morphology and function of the patient’s heart.
3. A physician performs a cardiac MRI with stress imaging, using contrast material to enhance visualization of the heart and evaluate the coronary arteries for any abnormalities.
4. For a patient with suspected coronary artery disease, a cardiac MRI is performed without contrast material, followed by the administration of contrast material and further sequences for stress imaging to assess the structure and function of the heart under stress.
5. During a cardiac MRI procedure, the provider utilizes contrast material and stress imaging to evaluate the morphology and function of the patient’s heart, specifically assessing the coronary arteries for any blockages or narrowing.
6. A patient undergoes a cardiac MRI with stress imaging, which involves the administration of contrast material to enhance visualization of the heart and evaluate its function under stress conditions.
7. During a cardiac MRI procedure, the provider performs stress imaging after obtaining images of the heart without contrast material, allowing for a comprehensive evaluation of the patient’s cardiac structure and function.
8. A physician administers a contrast agent during a cardiac MRI procedure to enhance visualization of the heart, followed by stress imaging to assess the coronary arteries for any abnormalities.