ICD Coding

Coding & Risk AdjustmentAsync jobs required

Two-pass ICD-10-CM extraction with evidence citations and governance validation.

ICD-10Medical codingMEATEvidence

About

General-purpose ICD-10-CM diagnosis coding from clinical documents or raw note text. Pass 1 extracts candidate codes; pass 2 validates them with governance rules and attaches MEAT evidence and supporting sentences with page-level bounding boxes.

This is the default destination for "medical coding" requests — it codes all documented diagnoses without the risk-adjustment lens (no HCC category mapping) that the HCC services apply.

How it works

  1. 1Document upload → OCR (skipped for the /text variant)
  2. 2Pass 1 — ICD-10 code extraction with canonical descriptions
  3. 3Pass 2 — validation, governance checks, MEAT evidence attachment

Intended use

  • •Encounter coding, chart completion, and real-time coding assist apps
  • •Routed to for generic "medical coding" / "ICD coding" requests (the platform's explicit disambiguation: generic coding → ICD, NOT HCC)
  • •Evidence-linked review UIs where each code highlights its supporting chart text

Key outputs

  • ▸result.ICD_descriptions[] — codes grouped by date of service
  • ▸Per code: description, canonical_description, reason, supporting_sentences with page + bbox
  • ▸meat_evidence — monitor/evaluate/assess/treat citation groups

Model comparison

F1 on Gwen's healthcare benchmark for this task — the Gwen pipeline vs the prompt-optimized model alone, with the uplift the pipeline adds, per model.

#ModelGwen pipelineModel onlyUplift
1
Claude Opus 4.8Best
0.953
0.952+0.001
2
GPT-5.5
0.937
0.860+0.077
3
Gemini 3.5 Flash
0.897
0.884+0.013

Endpoints

Try each endpoint with your signed-in session — usage counts toward your monthly budget.

Use synthetic data only. Do not submit real patient records or PHI when testing endpoints.

Limitations & caveats

  • –No HCC/RAF mapping — use HCC Retrospective or Prospective when risk adjustment is the goal
  • –Orthopedic operative notes (CPT + specialty ICD) are better served by the Ortho Coding service
  • –Runs 1–3 minutes; the async /jobs flow is mandatory for document uploads