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Building Auditable LLM Workflows for Medical Coding

Medical coding is a high-stakes extraction and verification problem, not a simple text generation task. Asking an LLM to read a long clinical note and directly output ICD codes risks hallucinated mappings, missed comorbidities, and results that are difficult for human coders to audit. A reliable medical coding system may benefit from an LLM-assisted workflow: extract clinical evidence, retrieve candidate codes, verify mappings, validate against the taxonomy, and route uncertainty to human review. The model should not be expected to memorize every code. Its job is to help produce auditable evidence inside a controlled workflow.