CPT® Code 75559

1. Indications

Cardiac magnetic resonance imaging (CMR) for morphology and function without contrast material, with stress imaging, is indicated for the following conditions:

• Coronary Artery Disease - To evaluate the presence and extent of coronary artery disease, which can lead to heart attacks and other serious cardiovascular issues.
• Assessment of Myocardial Damage - To determine the extent of damage to the heart muscle following a myocardial infarction (heart attack) or in cases of progressive heart disease.
• Evaluation of Heart Function - To assess the functional capacity of the heart, including biventricular function and ejection fraction, which are critical for managing heart failure and other cardiac conditions.
• Wall Motion Abnormalities - To identify and evaluate any abnormalities in wall motion, which can indicate underlying cardiac dysfunction or ischemia.
• Monitoring Treatment Progress - To monitor the effectiveness of ongoing treatment plans for cardiovascular problems and to make necessary adjustments based on the patient's response.

2. Procedure

The procedure for cardiac magnetic resonance imaging (CMR) for morphology and function without contrast material, with stress imaging, involves several key steps:

• Patient Preparation - The patient is prepared for the CMR procedure, which includes obtaining a thorough medical history and assessing any contraindications to the use of magnetic resonance imaging. The patient may be instructed to remove any metal objects and to wear a gown for the procedure.
• Setup and Imaging Plan - The imaging setup is supervised to ensure that the necessary anatomical imaging planes are established based on the patient's history and presenting symptoms. This step is crucial for obtaining accurate and relevant images of the heart.
• Initial Imaging - Initial study images are captured, and these images are reviewed to determine if additional planes or sequences are required. This review process ensures that all relevant anatomical details are visualized.
• Image Reconstruction - An independent workstation is utilized to create reconstructions of the heart's anatomy, including the chambers, valves, and major vessels. Adjustments and enhancements are made to optimize the visualization of the anatomy and to identify any areas of disease.
• Stress Imaging - Pharmacologic stress imaging sequences are obtained to evaluate wall motion under stress conditions. This typically involves capturing multiple cardiac segments at incremental levels of stress to assess how the heart functions when challenged.
• Image Review and Interpretation - The source and reformatted images are thoroughly reviewed and interpreted. This includes a motion (cinematography) review for structural findings in multiple planes, evaluation of biventricular function with ejection fraction, and identification of any wall motion abnormalities.
• Reporting Findings - A dictated report of the findings is generated, summarizing the results of the imaging study, including any abnormalities detected and their clinical significance.

3. Post-Procedure

After the cardiac magnetic resonance imaging procedure is completed, the patient may be monitored briefly to ensure there are no immediate adverse effects from the stress imaging. There are typically no specific post-procedure care requirements, as CMR is a non-invasive procedure. Patients can usually resume their normal activities immediately following the exam. The results of the imaging study will be discussed with the patient during a follow-up appointment, where the healthcare provider will review the findings and any necessary next steps in the management of their cardiovascular health.