Challenge: In medical coding, experts map unstructured clinical notes to alphanumeric codes for diagnoses and procedures.
Approach: They introduce ‘Code Like Humans’: a new agentic framework for medical coding with large language models that implements official coding guidelines for human experts.
Outcome: The proposed framework implements official coding guidelines for human experts and can support the full ICD-10 coding system (+70K labels).

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MedCodER: A Generative AI Assistant for Medical Coding (2025.naacl-industry)

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Challenge: Medical coding is time-consuming and error-prone due to large label space, lengthy text inputs, and the absence of supporting evidence annotations.
Approach: They propose a Generative AI framework for automatic medical coding that leverages extraction, retrieval, and re-ranking techniques as core components.
Outcome: The proposed framework outperforms existing methods on the International Classification of Diseases (ICD) code prediction scale.
Aligning AI Research with the Needs of Clinical Coding Workflows: Eight Recommendations Based on US Data Analysis and Critical Review (2025.acl-long)

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Challenge: Clinical coding is labour-intensive and error-prone, which has motivated research towards full automation of the process.
Approach: They propose to use AI to improve evaluation methods and propose new methods to assist clinical coders in their workflows.
Outcome: The proposed methods can be improved and improved on existing methods and the existing ones to assist coders in their workflows.
ICDAGENT: Empowering Agentic Large Language Models for Explainable Medical Coding (2026.acl-long)

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Challenge: Existing models lack convincing, human-understandable explanations, making them difficult for physicians to trust and use in practice.
Approach: They propose a framework that aims to automatically assign ICD codes to clinical notes while providing explicit justifications for each assignment.
Outcome: The proposed framework achieves effective ICD coding with accurate explanations using two collaborative LLM agents: a coding agent and a critical agent.
JointCoder: Exploring Automated ICD Coding on Real-World Chinese EHRs with a Multi-Agent Framework (2026.acl-demo)

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Challenge: Existing automated ICD coding systems face several fundamental challenges due to the limited availability of publicly available Chinese ICD datasets.
Approach: They propose to use a Chinese ICD coding dataset and a multi-agent framework to reformulate ICD as a joint disease-procedure coding task.
Outcome: The proposed system outperforms state-of-the-art methods on real-world Chinese ICD coding datasets and 1.7B-parameter models.
Less is More: Explainable and Efficient ICD Code Prediction with Clinical Entities (2025.acl-long)

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Challenge: Clinical coding is labor-intensive and prone to delays, leading to global backlogs.
Approach: They propose an approach that combines Named Entity Recognition (NER) and Assertion Classification (AC) to filter for clinically important content before supervised code prediction.
Outcome: The proposed approach reduces training time by over half on a standard evaluation dataset compared to current methods . it uses Named Entity Recognition (NER) and Assertion Classification (AC) to filter for clinically important content before supervised code prediction.
AnEMIC: A Framework for Benchmarking ICD Coding Models (2022.emnlp-demos)

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Challenge: Diagnostic coding is the task of assigning diagnosis codes defined by the ICD (International Classification of Diseases) standard to patient visits based on clinical notes.
Approach: They propose to use an ICD coding framework to train and benchmark models . they correct errors in preprocessing and provide an interactive demo to analyze the models based on custom inputs.
Outcome: The framework corrects errors in preprocessing and provides key models and weights trained on correctly preprocessed datasets.
Analyzing Code Embeddings for Coding Clinical Narratives (2021.findings-acl)

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Challenge: Recent work on automated ICD coding learn mappings between low-dimensional representations of clinical text reports and codes.
Approach: They propose novel neural networks for encoding medical codes based on textual, structural and statistical characteristics using a single deep learning baseline model.
Outcome: The proposed methods improve the accuracy of medical codes based on their textual, structural and statistical characteristics.
Toward Reliable Clinical Coding with Language Models: Verification and Lightweight Adaptation (2025.emnlp-industry)

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Challenge: Existing methods for clinical code verification fail to account for hierarchical misalignments . standardized coding systems such as ICD-10-CM1 ensure consistency across medical records.
Approach: They propose to use prompt engineering and small-scale fine-tuning to improve accuracy without the computational overhead of search-based methods.
Outcome: The proposed task is a standalone task and a pipeline component to address hierarchical near-miss errors without the computational overhead of search-based methods.
A Two-Stage Decoder for Efficient ICD Coding (2023.findings-acl)

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Challenge: Recent automated ICD coding efforts improve performance by encoding medical notes and codes with additional data and knowledge bases.
Approach: They propose a two-stage decoding mechanism to predict ICD codes using hierarchical properties of the codes to split the prediction into two steps: at first, predict the parent code and then predict the child code based on the previous prediction.
Outcome: Experiments on the public MIMIC-III data show that the proposed model performs well in single-model settings without external data or knowledge.
Beyond Label Attention: Transparency in Language Models for Automated Medical Coding via Dictionary Learning (2024.emnlp-main)

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Challenge: Current efforts in interpretability of medical coding rely heavily on label attention mechanisms, which often leads to the highlighting of extraneous tokens irrelevant to the ICD code.
Approach: They propose to leverage dictionary learning to extract sparsely activated representations from dense language models embedded in superposition to facilitate accurate interpretability.
Outcome: The proposed model extracts sparsely activated representations from dense language models in superposition, even when the highlighted tokens are medically irrelevant.

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