The procedure described is a complete cardiac MRI for morphology and function, which includes imaging without contrast, followed by imaging with contrast and further sequences, and also includes stress imaging. CPT® code 75563 accurately represents this entire service as a single, comprehensive code.

For the diagnoses, "systolic left ventricular congestive heart failure" is coded to I50.20 (Unspecified systolic (congestive) heart failure), as the documentation specifies "systolic" but does not indicate if it is acute or chronic. "Premature ventricular contractions" are specifically coded to I49.3 (Ventricular premature depolarization).

A. CPT® codes 75557 and 75559 do not include the stress imaging component. The ICD-10-CM codes are incorrect for the specified conditions.

B. Reporting both 75561 and 75563 is incorrect unbundling. 75563 is the all-encompassing code for the service. The ICD-10-CM codes are also incorrect.

D. CPT® code 75559 is an add-on code that cannot be reported alone and does not include the stress imaging component.

1. American Medical Association. (2023). CPT® 2024 Professional Edition.

Page 541

Code 75563: "Cardiac magnetic resonance imaging for morphology and function without contrast material(s)

followed by contrast material(s) and further sequences; with stress imaging." This description precisely matches the procedure performed.

Page 541

Codes 75557

+75559

75561: These codes describe components of the full service but are incorrect as they either omit the stress component (75557

+75559) or the contrast component (75561).

2. Centers for Medicare & Medicaid Services. (2023). ICD-10-CM Official Guidelines for Coding and Reporting FY 2024.

Section I.C.9.a.1

Heart Failure: The guidelines instruct to code for the specific type of heart failure if known. The term "systolic" directs the coder to subcategory I50.2-. As acuity is not specified

I50.20 is appropriate.

ICD-10-CM Tabular List of Diseases and Injuries:

Code I50.20: Unspecified systolic (congestive) heart failure.

Code I49.3: Ventricular premature depolarization. This is the specific code for premature ventricular contractions.

Code I49.1: Premature atrial depolarization. This is incorrect as the diagnosis is ventricular.