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.

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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.
Evaluation and LLM-Guided Learning of ICD Coding Rationales (2026.eacl-long)

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Challenge: Existing studies on the explainability of ICD coding rely on attention-based rationales and qualitative assessments conducted by physicians.
Approach: They propose to evaluate the explainability of rationales in ICD coding using a multi-granular rationale-annotated dataset.
Outcome: The proposed model improves the explainability of rationales in ICD coding by using human-annotated rationale-announced rationale models.
Code Like Humans: A Multi-Agent Solution for Medical Coding (2025.findings-emnlp)

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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).
Accurate and Well-Calibrated ICD Code Assignment Through Attention Over Diverse Label Embeddings (2024.eacl-long)

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Challenge: Existing approaches to assigning ICD codes to clinical text are time-consuming, labor intensive, and error-prone.
Approach: They propose to adapt a Transformer-based model to a longformer model and use it to encode clinical narratives.
Outcome: The proposed approach outperforms current state-of-the-art models in ICD coding with the label embeddings contributing to the good performance.
Clinical-Coder: Assigning Interpretable ICD-10 Codes to Chinese Clinical Notes (2020.acl-demos)

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Challenge: Existing methods of automatic coding prediction have been successful, but the interpretability of predicted codes is a challenge.
Approach: They propose an online system that can predict ICD codes for Chinese clinical notes by using a Dilated Convolutional Attention network with N-gram Matching mechanism.
Outcome: The proposed system is able to provide supporting information in clinical decision making.
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.
Travel on the ICD Tree: Benchmarking Agentic Reasoning for ICD Coding from Chinese Electronic Medical Records (2026.findings-acl)

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Challenge: Accurate International Classification of Diseases (ICD) coding is crucial for hospital management and healthcare data governance.
Approach: They propose a framework to evaluate ICD coding based on complete EMRs . they use a dataset of 560 real clinical records covering 434 common diseases .
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A Survey of LLM-based Agents in Medicine: How far are we from Baymax? (2025.findings-acl)

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Challenge: Large Language Models (LLMs) are transforming healthcare through their ability to understand and assist with medical tasks.
Approach: They analyze system profiles, clinical planning, medical reasoning frameworks, and external capacity enhancement.
Outcome: The findings highlight the future directions in medical reasoning, physical system integration, and training simulations.
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.
CoRelation: Boosting Automatic ICD Coding through Contextualized Code Relation Learning (2024.lrec-main)

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Challenge: Existing methods for boosting ICD coding performance lack a model for complex code relations . current methods overlook the importance of context in clinical notes .
Approach: They propose a contextualized and flexible framework to enhance learning of ICD code relations . they use clinical notes to model all possible code relations using a dependent learning paradigm .
Outcome: The proposed approach improves on six public ICD coding datasets compared to state-of-the-art models.

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