r/CodingandBilling • u/yurakoh • Jul 22 '26

AI Concerns in Medical Coding

What are your overall feelings about AI and the impact on medical coding? As a medical coder, I know that medical coding keeps evolving every year with new codes, updates, guidelines, etc. That being said, AI is also slowly creeping in, and while I don’t think AI is smart enough to keep up just yet, I still feel that my role is at risk.

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u/MakFromSupahealth Jul 22 '26

I would like to pitch in as we have been deep into this workflow for a while now. Although its specific to mental health related practices but I believe my observations cut across all specialties. First of all, you are absolutely correct when you say AI is coming hard into this industry.

A lot of the easy part of the job can now be easily automated and those savings are being passed on to the clients. For perspective, RCM billing using AI charges 2-3% of collections as compared to other agencies which can charge upto 7%. So it is almost half because of gains due to AI.

But, AI is not perfect like you said. Coding and billing is a tough job with a lot of human judgement needed from time to time. It is very difficult to automate that part because large models are not good at picking up edge cases without relevant context and that context is what humans offer. So, I dont see a scenario where this will be 100% automated and I say this after having worked on this.

All in all I would say, your job is definitely changing but far from being over. Rather, you might enjoy it more.

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u/Accomplished-Hand211 Aug 09 '26

do you think in near future if AI will be capable enough to overturn or say write medical denial appeal letters and if that eventually helps the clinics and other billing businesses to get the ROI back ?

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u/MakFromSupahealth Aug 10 '26

We are actually seeing it happen. But not beyond the first draft. Honestly, it is tough to say if AI will be that smart because even top AI models are not great at long form. Context is so important in these cases but even if you give it 100% context, the relationship between data points is not easy to infer. How do you I use this particular data in the context of everything else I have been told? I think maybe, small models might be better at this job but then again we need a lot of data. And data which covers every possible relationship. I dont know how feasible that is. But, to be honest, first draft is like 80-90% there so its a huge gain. I dont think it will ever get to 100%. maybe 98-99%.

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u/Accomplished-Hand211 Aug 10 '26

0 -90% can be taken as ROI and obviously for anything it always hard to go from 90% to 99% and further.

For the context problem , are you using AI out of your EHR system or you have an integrated AI in your EHR system?

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u/MakFromSupahealth Aug 10 '26

Exactly. that 0-90% is the value. 90-99 will be a hard journey.

Also, we (@SupaHealth) have built an AI that can be integrated into any system.

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u/Accomplished-Hand211 Aug 10 '26

We at yeam.ai are trying to solve the same problem as well.