icd10-cpt-coding-assistant

What This Skill Does

The ICD-10 & CPT Coding Assistant is an advanced AI-powered tool designed to bridge the gap between clinical documentation and medical billing. By utilizing natural language processing, the skill parses unstructured clinical notes—including SOAP notes, discharge summaries, and procedure reports—to extract pertinent medical diagnoses and service details. It then maps these findings to the official ICD-10-CM diagnosis codes and CPT procedure codes. Every recommendation is provided with a confidence score, helping healthcare providers and billing professionals identify how reliable the automated suggestion is, thereby streamlining the revenue cycle and reducing documentation errors.

Installation

To integrate this skill into your OpenClaw agent, execute the following command in your terminal:

clawhub install openclaw/skills/skills/aipoch-ai/icd10-cpt-coding-assistant

Ensure that you have the necessary environment variables configured if you are accessing private clinical databases, and confirm that your system permissions allow for file reading and data processing tasks.

Use Cases

This skill is engineered for medical billing departments, independent healthcare providers, and clinical auditors. Common use cases include:

• Rapid generation of draft coding for review by certified professional coders.
• Auditing existing clinical notes to identify potential gaps in documentation.
• Supporting medical scribes in ensuring that all procedures performed during a visit are captured for billing.
• Training scenarios for new staff to understand how specific keywords map to clinical codes.

Example Prompts

1. "Analyze the attached discharge summary and provide recommended ICD-10 codes for the patient's respiratory infection, ensuring a confidence threshold of at least 0.8."
2. "I have a SOAP note here for a follow-up visit. Please extract the CPT codes for the office visit and any associated services performed."
3. "Review this procedure report and tell me if the documentation supports the 99214 CPT code, and identify any missing information that might be preventing a higher confidence score."

Tips & Limitations

It is imperative to understand that this tool serves as an assistant, not a replacement for human judgment. Because medical billing involves complex regulatory compliance (such as HIPAA and CMS requirements), all recommendations must undergo mandatory human verification by a certified medical coder. The model performs best with clear, structured documentation. In cases of vague or ambiguous notes, the confidence scores will reflect this uncertainty (typically < 0.50). Always verify the final output against official coding manuals, as clinical guidelines and coding sets are subject to frequent updates. The tool does not perform billing submission; it is strictly a coding recommendation engine.