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ICD-10-PCS 2027 procedure code

4A12X4ZMonitoring of Cardiac Electrical Activity, External Approach

✓ Valid for 2027

Code unchanged since ICD-10-PCS took effect on October 1, 2015. Source: official FY2027 ICD-10-PCS release from CMS. Page updated September 29, 2026. About our data

About 4A12X4Z

4A12X4Z is the ICD-10-PCS code for a monitoring procedure on the cardiac using an external approach with electrical activity. In ICD-10-PCS, monitoring means determining the level of a physiological or physical function repetitively over a period of time.

In plain terms, this corresponds to Electrographic monitoring and Apexcardiogram (with ECG lead), the ICD-9-CM procedure titles it maps to (89.54 and 89.57).

For a different body part, codes include 4A10X4Z (central nervous), 4A11X4Z (peripheral nervous), 4A1HX4Z (products of conception, cardiac) and 4A1JX4Z (products of conception, nervous).

The same procedure with a different approach is coded 4A1204Z (open), 4A1234Z (percutaneous), 4A1274Z (via natural or artificial opening) and 4A1284Z (via natural or artificial opening endoscopic).

With a different device, use 4A12X9Z (output), 4A12XCZ (rate), 4A12XFZ (rhythm) and 4A12XHZ (sound).

It doesn't appear in the MS-DRG procedure index, so on its own it doesn't change the DRG assignment.

It has been valid since ICD-10-PCS took effect on October 1, 2015.

What each character means

1. Section
4Measurement and Monitoring
2. Body System
APhysiological Systems
3. Operation
1Monitoring

Determining the level of a physiological or physical function repetitively over a period of time

4. Body System
2Cardiac
5. Approach
XExternal

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

6. Function / Device
4Electrical Activity
7. Qualifier
ZNo Qualifier

Other versions of this procedure

Different qualifier

ICD-9-CM equivalent

Converter →
  • 89.54Electrographic monitoringapproximate
  • 89.57Apexcardiogram (with ECG lead)approximate

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
  • No changes since FY2016.

Common questions about 4A12X4Z

Is 4A12X4Z a valid ICD-10-PCS code for 2027?

Yes. 4A12X4Z is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

What is the ICD-9 procedure code for 4A12X4Z?

The CMS GEMs map 4A12X4Z to ICD-9-CM 89.54 (Electrographic monitoring) and 89.57 (Apexcardiogram (with ECG lead)).