Summary & Overview
CPT 75565: Cardiac MRI with Velocity Flow Mapping
CPT code 75565 designates an add-on imaging procedure for velocity flow mapping performed alongside cardiac MRI to assess structural and functional cardiac abnormalities. As an adjunct to standard cardiac MRI sequences, velocity flow mapping provides quantitative flow and hemodynamic data that can alter diagnosis, surgical planning, and longitudinal management for conditions such as valvular disease, shunts, and congenital heart disease. Nationally, accurate coding for this add-on service matters for clinical documentation, appropriate billing, and enabling comparability across providers and payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for use of the code, typical sites of service, and the types of benchmarks and payment issues that commonly arise when billing add-on cardiac MRI services. The publication highlights common policy considerations affecting coverage and payment for advanced cardiac imaging, explains where CPT code 75565 fits within the cardiac MRI service line, and summarizes implications for provider documentation and claim assembly.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 75565 is an add-on diagnostic imaging code used when a provider performs velocity flow mapping in conjunction with cardiac magnetic resonance imaging (MRI). The service documents flow dynamics to examine defects or abnormalities in the structure and function of the heart.
Service type: Cardiac MRI with velocity flow mapping (add-on service)
Typical site of service: Hospital outpatient imaging center or independent outpatient radiology/Cardiology imaging facility
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Clinical & Coding Specifications
Clinical Context
A 58-year-old male with a history of hypertension and progressive exertional dyspnea is referred for cardiac magnetic resonance imaging (MRI) to evaluate suspected dilated cardiomyopathy and to quantify valvular regurgitation. The cardiologist orders a standard cardiac MRI with velocity-encoded phase-contrast flow mapping to measure transvalvular flow volumes, peak velocities, and regurgitant fraction.
The patient arrives at an outpatient radiology center. After screening for MRI safety (implanted devices, ferromagnetic materials), intravenous access is established for contrast administration when indicated. The technologist acquires cine sequences to assess chamber size and function, late gadolinium enhancement to evaluate scar, and performs velocity flow mapping sequences across the aortic and mitral valves. The interpreting cardiovascular radiologist or cardiologist documents measured stroke volumes, forward flow, regurgitant volumes and fractions, and comments on flow abnormalities. The velocity flow mapping is reported as an add-on component to the primary cardiac MRI study using the add-on 75565 when appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the physician interpretation separate from technical component for the MRI study |