ICD-10 Code
International Classification of Diseases, 10th Revision
Mar 26, 2017

Procedure Terms used in “Measurement and Monitoring”

Measurement and monitoring section codes represent procedures for determining the level of a physiological or physical function. Measurement and monitoring procedure codes have a first character value of “4”. The second character value for body system is either physiological systems or physiological devices. There are two root operations in the measurement and monitoring section, as defined below:

  • Measurement: Determining the level of a physiological or physical function at a point in time
  • Monitoring: Determining the level of a physiological or physical function repetitively over a period of time

The 4th character specifies the body system measured or monitored. The fifth character specifies approaches as defined in the medical and surgical section. Instead of specifying device, the sixth character specifies the physiological or physical function being measured or monitored. Examples of physiological or physical function values are conductivity, metabolism, pulse, temperature, and volume. If a device used to perform the measurement or monitoring is inserted and left in, then insertion of the device is coded as a separate medical and surgical section procedure. The seventh character qualifier contains specific values as needed to further specify the body part (e.g., central, portal, pulmonary) or a variation of the procedure performed (e.g., ambulatory, stress).

Examples of typical procedures coded in this section are EKG, EEG, and cardiac catheterization. An EKG is the measurement of cardiac electrical activity, while an EEG is the measurement of electrical activity of the central nervous system. A cardiac catheterization performed to measure the pressure in the heart is coded as the measurement of cardiac pressure by percutaneous approach.


Terms for Measurement and Monitoring

External
When used as Approach
Procedures performed directly on the skin or mucous membrane and procedures performed indirectly by the application of external force through the skin or mucous membrane
Measurement
Determining the level of a physiological or physical function at a point in time
Monitoring
Determining the level of a physiological or physical function repetitively over a period of time
Open
When used as Approach
Cutting through the skin or mucous membrane and any other body layers necessary to expose the site of the procedure
Percutaneous
When used as Approach
Entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach the site of the procedure
Percutaneous Endoscopic
When used as Approach
Entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach and visualize the site of the procedure
Via Natural or Artificial Opening
When used as Approach
Entry of instrumentation through a natural or artificial external opening to reach the site of the procedure
Via Natural or Artificial Opening Endoscopic
When used as Approach
Entry of instrumentation through a natural or artificial external opening to reach and visualize the site of the procedure

When ICD 10 was implemented on October 1, 2015, it did not affect physicians', outpatient facilities', and hospital outpatient departments' use of CPT codes on Medicare Fee-For-Service claims. Providers should continue to use CPT codes to report these services.