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CPTCoder: A Reliable LLM System for Medical Procedure Code Prediction
来源日期（仅到月份） 2026-07
来源记录日期 2026-07
雷达观测 2026-11-01 22:08
摘要
We present CPTCoder, a human-in-the-loop system that predicts standardized medical procedure codes from clinical text. Clinical procedure coding is an extreme multi-label classification problem over a long-tailed space of short numeric identifiers, where a single-digit difference denotes an entirely different procedure. CPTCoder adapts an instruction-tuned LLM with a code-aware vocabulary and constrained decoding that guarantees all outputs are valid codes. To support human review, we derive per-code posterior inclusion probabilities from n-best reweighting, producing interpretable confidence scores that rank predictions and flag uncertain cases. A post-decoding constraint repair step enforces mutual-exclusion rules between conflicting codes. To enable reproducible research in this underexplored setting, we release MIMIC-CPT, a PhysioNet-accessible benchmark of 37,885 expert-cleaned report–code pairs with a deliberately hardened test split: 88% of test examples contain label combinations unseen during training, and over a third include codes with five or fewer training occurrences. We additionally provide 413,085 weakly aligned pairs and evaluate on a separate live dataset from a hospital, which includes out-of-domain radiology reports with billing-expert-verified labels. CPTCoder achieves 0.61 and 0.51 micro-F1 on the hardened MIMIC split and Hospital-298 respectively, outperforming the strongest baseline by 12 and 5 absolute points while reducing digit-level near-miss errors.
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记录 #1 · 2026-07 · 最新观测版本
CPTCoder: A Reliable LLM System for Medical Procedure Code Prediction
We present CPTCoder, a human-in-the-loop system that predicts standardized medical procedure codes from clinical text. Clinical procedure coding is an extreme multi-label classification problem over a long-tailed space of short numeric identifiers, where a single-digit difference denotes an entirely different procedure. CPTCoder adapts an instruction-tuned LLM with a code-aware vocabulary and constrained decoding that guarantees all outputs are valid codes. To support human review, we derive per-code posterior inclusion probabilities from n-best reweighting, producing interpretable confidence scores that rank predictions and flag uncertain cases. A post-decoding constraint repair step enforces mutual-exclusion rules between conflicting codes. To enable reproducible research in this underexplored setting, we release MIMIC-CPT, a PhysioNet-accessible benchmark of 37,885 expert-cleaned report–code pairs with a deliberately hardened test split: 88% of test examples contain label combinations unseen during training, and over a third include codes with five or fewer training occurrences. We additionally provide 413,085 weakly aligned pairs and evaluate on a separate live dataset from a hospital, which includes out-of-domain radiology reports with billing-expert-verified labels. CPTCoder achieves 0.61 and 0.51 micro-F1 on the hardened MIMIC split and Hospital-298 respectively, outperforming the strongest baseline by 12 and 5 absolute points while reducing digit-level near-miss errors.
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