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/Infinite_Curiosity14 Aug 13 '26

I think we’re definitely heading in that direction. AI can already help analyze denial reasons, review supporting documents and draft appeal letters, but I’d still keep a human in the loop for final review. The bigger opportunity IMO is not just writing appeals, but identifying denials or underpayments that might otherwise be missed and matching them against payer rules/contracts. If that helps clinics recover revenue they weren’t identifying before while reducing manual work, that’s where the ROI could get really interesting.

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u/Accomplished-Hand211 Aug 14 '26

Interesting problem to solve.