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Automated Medical Coding Pipeline

Manual medical coding runs a 10–20% error rate and bleeds $1B+ annually from non-compliant claims, in a market projected to reach $8.4B by 2033.

Under 7.66% error rate · 3× off the shelf AI baseline · shipped in 2 months
Built
Two-stage retrieval pipeline grounded in three official CMS sources, with Medicaid and Medicare compliance rules built into the foundation of the system.
Approach
Step 1: find candidate codes from authoritative sources. Step 2: pick the right code under strict rules. Step 3: check compliance. Replaced a default large-language-model approach that capped below 70% accuracy.
Impact
Under 7.66% error rate · 3× off the shelf AI baseline · shipped in 2 months
Skills
PythonRAGVector DBLLMsICD-10CPTCMS Sources