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Icd10 Cpt Coding Assistant

by @aipoch-ai

Automatically recommend ICD-10 diagnosis codes and CPT procedure codes from clinical notes. Trigger when: user provides clinical notes, patient encounter sum...

Versionv0.1.0
Downloads746
TERMINAL
clawhub install icd10-cpt-coding-assistant

πŸ“– About This Skill


name: icd10-cpt-coding-assistant description: 'Automatically recommend ICD-10 diagnosis codes and CPT procedure codes from clinical notes. Trigger when: user provides clinical notes, patient encounter summaries, discharge summaries, or asks for medical coding assistance. Use for healthcare providers, medical coders, and billing professionals who need accurate code recommendations.' version: 1.0.0 category: Clinical tags: [] author: AIPOCH license: MIT status: Draft risk_level: Medium skill_type: Tool/Script owner: AIPOCH reviewer: '' last_updated: '2026-02-06'

ICD-10 & CPT Coding Assistant

A medical coding assistant that parses clinical notes and recommends appropriate ICD-10 diagnosis codes and CPT procedure codes with confidence scoring.

Overview

This skill analyzes clinical documentation to extract relevant medical information and map it to standardized coding systems:

  • ICD-10-CM: International Classification of Diseases, 10th Revision, Clinical Modification (diagnosis codes)
  • CPT: Current Procedural Terminology (procedure/service codes)
  • Technical Difficulty: HIGH ⚠️

    > ⚠️ HUMAN REVIEW REQUIRED: Medical coding directly impacts billing, reimbursement, and clinical documentation. All recommendations must be verified by a certified medical coder or healthcare provider.

    Usage

    python scripts/main.py --input "clinical_note.txt" [--format json|text]
    

    Or use programmatically:

    from scripts.main import CodingAssistant

    assistant = CodingAssistant() result = assistant.analyze("Patient presents with acute bronchitis...") print(result.icd10_codes) print(result.cpt_codes)

    Parameters

    | Parameter | Type | Default | Required | Description | |-----------|------|---------|----------|-------------| | --input, -i | string | - | Yes | Path to clinical note file | | --format, -f | string | json | No | Output format (json, text) | | --output, -o | string | stdout | No | Output file path | | --confidence-threshold | float | 0.7 | No | Minimum confidence score (0.0-1.0) | | --include-alternatives | flag | false | No | Include alternative code suggestions |

    Input Format

    Accepts clinical notes in various formats:

  • Free-text narrative
  • SOAP notes (Subjective, Objective, Assessment, Plan)
  • Discharge summaries
  • Progress notes
  • Procedure reports
  • Output Format

    ICD-10 Recommendations

    {
      "icd10_codes": [
        {
          "code": "J20.9",
          "description": "Acute bronchitis, unspecified",
          "confidence": 0.92,
          "evidence": ["cough for 5 days", "wheezing on exam"],
          "alternatives": ["J20.0", "J44.9"]
        }
      ]
    }
    

    CPT Recommendations

    {
      "cpt_codes": [
        {
          "code": "99213",
          "description": "Office visit, established patient, moderate complexity",
          "confidence": 0.85,
          "evidence": ["detailed history", "low complexity decision making"],
          "time": "20 minutes"
        }
      ]
    }
    

    Confidence Scoring

  • 0.90-1.00: High confidence - Clear documentation, unambiguous mapping
  • 0.70-0.89: Medium confidence - Good documentation, some interpretation required
  • 0.50-0.69: Low confidence - Incomplete documentation, multiple possibilities
  • <0.50: Very low confidence - Insufficient information, manual review essential
  • Limitations

    1. No Medical Advice: This tool does not provide clinical advice or diagnoses 2. Coding Complexity: Cannot handle all coding nuances (comorbidities, sequencing, modifiers) 3. Regional Variations: May not account for payer-specific coding requirements 4. Updates: Code sets may not reflect the latest annual updates

    References

    See references/ folder for:

  • icd10_common_codes.json: Frequently used ICD-10 codes by specialty
  • cpt_common_codes.json: Frequently used CPT codes by specialty
  • coding_guidelines.md: General coding guidelines and conventions
  • Safety & Compliance

  • HIPAA Awareness: Ensure de-identification of PHI before processing
  • Audit Trail: Maintain records of automated recommendations for compliance
  • Human Oversight: All codes must be reviewed and approved by qualified personnel
  • Dependencies

  • Python 3.8+
  • See requirements.txt for package dependencies
  • Risk Assessment

    | Risk Indicator | Assessment | Level | |----------------|------------|-------| | Code Execution | Python/R scripts executed locally | Medium | | Network Access | No external API calls | Low | | File System Access | Read input files, write output files | Medium | | Instruction Tampering | Standard prompt guidelines | Low | | Data Exposure | Output files saved to workspace | Low |

    Security Checklist

  • [ ] No hardcoded credentials or API keys
  • [ ] No unauthorized file system access (../)
  • [ ] Output does not expose sensitive information
  • [ ] Prompt injection protections in place
  • [ ] Input file paths validated (no ../ traversal)
  • [ ] Output directory restricted to workspace
  • [ ] Script execution in sandboxed environment
  • [ ] Error messages sanitized (no stack traces exposed)
  • [ ] Dependencies audited
  • Prerequisites

    # Python dependencies
    pip install -r requirements.txt
    

    Evaluation Criteria

    Success Metrics

  • [ ] Successfully executes main functionality
  • [ ] Output meets quality standards
  • [ ] Handles edge cases gracefully
  • [ ] Performance is acceptable
  • Test Cases

    1. Basic Functionality: Standard input β†’ Expected output 2. Edge Case: Invalid input β†’ Graceful error handling 3. Performance: Large dataset β†’ Acceptable processing time

    Lifecycle Status

  • Current Stage: Draft
  • Next Review Date: 2026-03-06
  • Known Issues: None
  • Planned Improvements:
  • - Performance optimization - Additional feature support

    πŸ’‘ Examples

    python scripts/main.py --input "clinical_note.txt" [--format json|text]
    

    Or use programmatically:

    from scripts.main import CodingAssistant

    assistant = CodingAssistant() result = assistant.analyze("Patient presents with acute bronchitis...") print(result.icd10_codes) print(result.cpt_codes)

    βš™οΈ Configuration

    # Python dependencies
    pip install -r requirements.txt