Medical Coding Assistant
AI-powered ICD-10 and CPT code suggestions from clinical documentation.
The Challenge
Medical coders were overwhelmed with documentation volume, leading to coding backlogs and delayed revenue. Each chart required careful analysis to select appropriate codes.
Coding errors resulted in claim denials, requiring expensive rework and delaying payment. The complexity of ICD-10 made accurate coding increasingly difficult.
Experienced coders were scarce and expensive, while training new coders took months. The talent gap was widening.
“Every coding error costs us twice: once in the denial, and again in the rework.”
The Solution
We built an AI assistant that analyzes clinical documentation and suggests appropriate ICD-10 and CPT codes with supporting rationale.
The system explains why each code is recommended, helping coders make faster, more confident decisions.
Integration with existing coding workflows means suggestions appear right where coders work.
Key Features
- Clinical documentation analysis
- ICD-10 and CPT code suggestions
- Code rationale explanations
- Specificity recommendations for higher reimbursement
- Integration with coding workflows
Implementation
Technical Approach
- Claude API with medical coding fine-tuning
- ICD-10 and CPT code database integration
- EHR system integration via HL7/FHIR
- React coding interface overlay
- Analytics dashboard for coding metrics
Change Management
- Coder training on AI-assisted workflow
- Parallel coding during validation
- Regular accuracy audits
- Feedback mechanism for continuous improvement
Results & Impact
- Coding backlog eliminated
- Denial rates dropped significantly
- Junior coders productive faster with AI assistance
- Revenue cycle velocity improved across the board