AI Medical Coding Agent

Clinical NLP reads every document in the encounter record — discharge summary, operative notes, pathology reports, radiology interpretations, nursing assessments, lab results, and physician progress notes — extracting diagnoses, procedures, conditions, anatomical sites, acuity indicators, and clinical context with 96.7%+ weighted NLP accuracy across all document types

Every assigned code traces to its source documentation: the specific document, section, date, and clinical language that supports the code selection is surfaced alongside the code for coder review — enabling exception-based review rather than full re-coding, and providing a fully defensible audit trail if the assignment is ever challenged by a payer or OIG auditor

MS-DRG and APR-DRG assignment is optimised at the time of code selection: the agent identifies every CC and MCC candidate in the clinical record, surfaces the specific documentation supporting each, and generates a coding query for the attending physician when CC/MCC-level complexity is present but not documented with the specificity required for DRG capture

The compliance validation layer runs every code combination through 12,000+ CMS NCCI procedure-to-procedure and medically unlikely edits, AHA Coding Clinic guidance, and payer-specific bundling rules — catching unbundling violations, modifier conflicts, and sequencing errors before the claim is generated