Summary & Overview
CPT 75561: Cardiac MRI Without and With Contrast
CPT code 75561 denotes a diagnostic cardiac magnetic resonance imaging (MRI) procedure performed both without and then with intravenous contrast to evaluate cardiac structure and function. This code is widely used in cardiovascular imaging to characterize ventricular function, myocardial tissue properties, and vascular anatomy when contrast enhancement is needed after initial noncontrast sequences. Its national relevance stems from the role of cardiac MRI in diagnosis, treatment planning, and management of heart disease across tertiary centers and outpatient imaging facilities.
Key payers covered in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage considerations and payer-specific coding practices, benchmark utilization patterns, and clinical context explaining when noncontrast plus contrast cardiac MRI is clinically indicated. The publication also summarizes common modifier usage and related billing considerations where available.
This piece is intended for billing managers, radiology and cardiology department leaders, and payers seeking concise guidance on coding and billing for combined noncontrast and contrast cardiac MRI. It provides actionable clarity on the service definition, sites of service, and what to expect in payer interactions. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
CPT code 75561 describes a cardiac magnetic resonance imaging (MRI) study in which the provider performs imaging of cardiac structure and function, initiating the exam without contrast and then continuing with administration of contrast. The service type is diagnostic cardiac MRI with and without contrast. The typical site of service is an outpatient imaging center or hospital radiology/cardiac imaging department, where MRI scanners and contrast administration capabilities are available.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with known ischemic cardiomyopathy and progressive dyspnea is referred for a comprehensive cardiac magnetic resonance imaging (MRI) study. The ordering cardiologist requests an initial non-contrast assessment to evaluate cardiac morphology, ventricular volumes, and function, followed by gadolinium-based contrast to assess myocardial perfusion and delayed enhancement for viability and scar characterization. The clinical workflow begins with registration and screening for MRI safety and contrast contraindications; baseline non-contrast sequences are acquired (cine imaging, T1/T2 mapping as indicated); intravenous access is established and renal function reviewed; weight-based gadolinium contrast is administered; contrast-enhanced perfusion and late gadolinium enhancement sequences are obtained; images are processed and interpreted by a board-certified cardiologist or radiologist with cardiac MRI expertise. Typical site of service is an outpatient radiology or cardiology imaging center or hospital outpatient department with MRI capability and cardiac monitoring. Usual documentation includes indication, contrast administration record, sequence protocols, personnel present, and an interpretive report detailing ventricular function, wall motion, perfusion defects, and late enhancement findings.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician interpretation when the facility bills technical component separately |