{"id":"https://openalex.org/W7133567597","doi":"https://doi.org/10.3390/informatics13030039","title":"Integrating Agentic Artificial Intelligence to Automate International Classification of Diseases, Tenth Revision, Medical Coding","display_name":"Integrating Agentic Artificial Intelligence to Automate International Classification of Diseases, Tenth Revision, Medical Coding","publication_year":2026,"publication_date":"2026-03-04","ids":{"openalex":"https://openalex.org/W7133567597","doi":"https://doi.org/10.3390/informatics13030039"},"language":"en","primary_location":{"id":"doi:10.3390/informatics13030039","is_oa":true,"landing_page_url":"https://doi.org/10.3390/informatics13030039","pdf_url":"https://www.mdpi.com/2227-9709/13/3/39/pdf","source":{"id":"https://openalex.org/S2738238905","display_name":"Informatics","issn_l":"2227-9709","issn":["2227-9709"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Informatics","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.mdpi.com/2227-9709/13/3/39/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5121030021","display_name":"Kitti Akkhawatthanakun","orcid":null},"institutions":[{"id":"https://openalex.org/I25399158","display_name":"Mahidol University","ror":"https://ror.org/01znkr924","country_code":"TH","type":"education","lineage":["https://openalex.org/I25399158"]}],"countries":["TH"],"is_corresponding":true,"raw_author_name":"Kitti Akkhawatthanakun","raw_affiliation_strings":["Department of Computer Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand"],"affiliations":[{"raw_affiliation_string":"Department of Computer Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand","institution_ids":["https://openalex.org/I25399158"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5121124116","display_name":"Lalita Narupiyakul","orcid":null},"institutions":[{"id":"https://openalex.org/I25399158","display_name":"Mahidol University","ror":"https://ror.org/01znkr924","country_code":"TH","type":"education","lineage":["https://openalex.org/I25399158"]}],"countries":["TH"],"is_corresponding":false,"raw_author_name":"Lalita Narupiyakul","raw_affiliation_strings":["Department of Computer Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand"],"affiliations":[{"raw_affiliation_string":"Department of Computer Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand","institution_ids":["https://openalex.org/I25399158"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5064821427","display_name":"Konlakorn Wongpatikaseree","orcid":"https://orcid.org/0000-0003-4444-1396"},"institutions":[{"id":"https://openalex.org/I25399158","display_name":"Mahidol University","ror":"https://ror.org/01znkr924","country_code":"TH","type":"education","lineage":["https://openalex.org/I25399158"]}],"countries":["TH"],"is_corresponding":false,"raw_author_name":"Konlakorn Wongpatikaseree","raw_affiliation_strings":["Department of Computer Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand"],"affiliations":[{"raw_affiliation_string":"Department of Computer Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand","institution_ids":["https://openalex.org/I25399158"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5128088094","display_name":"Narit Hnoohom","orcid":null},"institutions":[{"id":"https://openalex.org/I25399158","display_name":"Mahidol University","ror":"https://ror.org/01znkr924","country_code":"TH","type":"education","lineage":["https://openalex.org/I25399158"]}],"countries":["TH"],"is_corresponding":false,"raw_author_name":"Narit Hnoohom","raw_affiliation_strings":["Department of Computer Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand"],"affiliations":[{"raw_affiliation_string":"Department of Computer Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand","institution_ids":["https://openalex.org/I25399158"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5064275378","display_name":"Chakkrit Termritthikun","orcid":"https://orcid.org/0000-0002-1508-3123"},"institutions":[{"id":"https://openalex.org/I66200439","display_name":"Naresuan University","ror":"https://ror.org/03e2qe334","country_code":"TH","type":"education","lineage":["https://openalex.org/I66200439"]}],"countries":["TH"],"is_corresponding":false,"raw_author_name":"Chakkrit Termritthikun","raw_affiliation_strings":["School of Renewable Energy and Smart Grid Technology (SGtech), Naresuan University, Phitsanulok 65000, Thailand"],"affiliations":[{"raw_affiliation_string":"School of Renewable Energy and Smart Grid Technology (SGtech), Naresuan University, Phitsanulok 65000, Thailand","institution_ids":["https://openalex.org/I66200439"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5112731852","display_name":"Paisarn Muneesawang","orcid":"https://orcid.org/0009-0001-4218-5176"},"institutions":[{"id":"https://openalex.org/I25399158","display_name":"Mahidol University","ror":"https://ror.org/01znkr924","country_code":"TH","type":"education","lineage":["https://openalex.org/I25399158"]}],"countries":["TH"],"is_corresponding":true,"raw_author_name":"Paisarn Muneesawang","raw_affiliation_strings":["Department of Computer Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand"],"affiliations":[{"raw_affiliation_string":"Department of Computer Engineering, Faculty of Engineering, Mahidol University, Nakorn Pathom 73170, Thailand","institution_ids":["https://openalex.org/I25399158"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":6,"corresponding_author_ids":["https://openalex.org/A5112731852","https://openalex.org/A5121030021"],"corresponding_institution_ids":["https://openalex.org/I25399158"],"apc_list":{"value":1600,"currency":"CHF","value_usd":1732},"apc_paid":{"value":1600,"currency":"CHF","value_usd":1732},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.66360388,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"13","issue":"3","first_page":"39","last_page":"39"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T14400","display_name":"Medical Coding and Health Information","score":0.7128000259399414,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T14400","display_name":"Medical Coding and Health Information","score":0.7128000259399414,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.13019999861717224,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.027799999341368675,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/coding","display_name":"Coding (social sciences)","score":0.6240000128746033},{"id":"https://openalex.org/keywords/audit","display_name":"Audit","score":0.6108999848365784},{"id":"https://openalex.org/keywords/automation","display_name":"Automation","score":0.39980000257492065},{"id":"https://openalex.org/keywords/confidentiality","display_name":"Confidentiality","score":0.3483000099658966},{"id":"https://openalex.org/keywords/trimming","display_name":"Trimming","score":0.3467000126838684},{"id":"https://openalex.org/keywords/false-positive-paradox","display_name":"False positive paradox","score":0.32100000977516174},{"id":"https://openalex.org/keywords/troubleshooting","display_name":"Troubleshooting","score":0.31949999928474426}],"concepts":[{"id":"https://openalex.org/C179518139","wikidata":"https://www.wikidata.org/wiki/Q5140297","display_name":"Coding (social sciences)","level":2,"score":0.6240000128746033},{"id":"https://openalex.org/C199521495","wikidata":"https://www.wikidata.org/wiki/Q181487","display_name":"Audit","level":2,"score":0.6108999848365784},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.5511000156402588},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.4740999937057495},{"id":"https://openalex.org/C115901376","wikidata":"https://www.wikidata.org/wiki/Q184199","display_name":"Automation","level":2,"score":0.39980000257492065},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.36079999804496765},{"id":"https://openalex.org/C71745522","wikidata":"https://www.wikidata.org/wiki/Q2476929","display_name":"Confidentiality","level":2,"score":0.3483000099658966},{"id":"https://openalex.org/C56951928","wikidata":"https://www.wikidata.org/wiki/Q3539213","display_name":"Trimming","level":2,"score":0.3467000126838684},{"id":"https://openalex.org/C64869954","wikidata":"https://www.wikidata.org/wiki/Q1859747","display_name":"False positive paradox","level":2,"score":0.32100000977516174},{"id":"https://openalex.org/C147494362","wikidata":"https://www.wikidata.org/wiki/Q2078905","display_name":"Troubleshooting","level":2,"score":0.31949999928474426},{"id":"https://openalex.org/C2777286243","wikidata":"https://www.wikidata.org/wiki/Q5591926","display_name":"Grading (engineering)","level":2,"score":0.30410000681877136},{"id":"https://openalex.org/C154874363","wikidata":"https://www.wikidata.org/wiki/Q3518464","display_name":"Medical classification","level":2,"score":0.3027999997138977},{"id":"https://openalex.org/C108583219","wikidata":"https://www.wikidata.org/wiki/Q197536","display_name":"Deep learning","level":2,"score":0.3021000027656555},{"id":"https://openalex.org/C2522767166","wikidata":"https://www.wikidata.org/wiki/Q2374463","display_name":"Data science","level":1,"score":0.2987000048160553},{"id":"https://openalex.org/C204321447","wikidata":"https://www.wikidata.org/wiki/Q30642","display_name":"Natural language processing","level":1,"score":0.29440000653266907},{"id":"https://openalex.org/C2779530757","wikidata":"https://www.wikidata.org/wiki/Q1207505","display_name":"Quality (philosophy)","level":2,"score":0.2750000059604645},{"id":"https://openalex.org/C106436119","wikidata":"https://www.wikidata.org/wiki/Q836575","display_name":"Quality assurance","level":3,"score":0.2702000141143799},{"id":"https://openalex.org/C199033989","wikidata":"https://www.wikidata.org/wiki/Q1318295","display_name":"Narrative","level":2,"score":0.26190000772476196}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.3390/informatics13030039","is_oa":true,"landing_page_url":"https://doi.org/10.3390/informatics13030039","pdf_url":"https://www.mdpi.com/2227-9709/13/3/39/pdf","source":{"id":"https://openalex.org/S2738238905","display_name":"Informatics","issn_l":"2227-9709","issn":["2227-9709"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Informatics","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:4d819b66c4864c5db63aba0d44ceee2c","is_oa":true,"landing_page_url":"https://doaj.org/article/4d819b66c4864c5db63aba0d44ceee2c","pdf_url":null,"source":{"id":"https://openalex.org/S112646816","display_name":"SHILAP Revista de lepidopterolog\u00eda","issn_l":"0300-5267","issn":["0300-5267","2340-4078"],"is_oa":true,"is_in_doaj":true,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Informatics, Vol 13, Iss 3, p 39 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3390/informatics13030039","is_oa":true,"landing_page_url":"https://doi.org/10.3390/informatics13030039","pdf_url":"https://www.mdpi.com/2227-9709/13/3/39/pdf","source":{"id":"https://openalex.org/S2738238905","display_name":"Informatics","issn_l":"2227-9709","issn":["2227-9709"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Informatics","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.44351205229759216,"display_name":"Partnerships for the goals","id":"https://metadata.un.org/sdg/17"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320322401","display_name":"Mahidol University","ror":"https://ror.org/01znkr924"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7133567597.pdf","grobid_xml":"https://content.openalex.org/works/W7133567597.grobid-xml"},"referenced_works_count":35,"referenced_works":["https://openalex.org/W1534477342","https://openalex.org/W1976526581","https://openalex.org/W2076749608","https://openalex.org/W2096664202","https://openalex.org/W2098044946","https://openalex.org/W2607041163","https://openalex.org/W2664267452","https://openalex.org/W2798843374","https://openalex.org/W2889577585","https://openalex.org/W2911489562","https://openalex.org/W2963716420","https://openalex.org/W2979826702","https://openalex.org/W3019166713","https://openalex.org/W3035294872","https://openalex.org/W3131759468","https://openalex.org/W3167829962","https://openalex.org/W4213009331","https://openalex.org/W4224541024","https://openalex.org/W4287854971","https://openalex.org/W4313439128","https://openalex.org/W4362686850","https://openalex.org/W4366835582","https://openalex.org/W4383535867","https://openalex.org/W4384071683","https://openalex.org/W4384452259","https://openalex.org/W4385571315","https://openalex.org/W4390992112","https://openalex.org/W4391971084","https://openalex.org/W4394579747","https://openalex.org/W4394857110","https://openalex.org/W4394943312","https://openalex.org/W4401793114","https://openalex.org/W4402391818","https://openalex.org/W4402407635","https://openalex.org/W4412884948"],"related_works":[],"abstract_inverted_index":{"Automating":[0],"ICD-10":[1],"coding":[2,165],"from":[3,131],"discharge":[4],"summaries":[5,63],"remains":[6,171],"demanding":[7],"because":[8,78],"coders":[9,79],"analyze":[10],"clinical":[11,164],"narratives":[12],"while":[13,90,141,167],"justifying":[14],"decisions.":[15],"This":[16],"study":[17],"compares":[18],"three":[19],"automation":[20],"patterns:":[21],"PLM-ICD":[22,44,85],"as":[23,133,138,153],"a":[24,40,134,139],"standalone":[25],"deep":[26],"learning":[27],"system":[28],"emitting":[29],"15":[30,93,117],"codes":[31],"per":[32],"case,":[33],"LLM-only":[34,95],"generation":[35,96],"with":[36],"full":[37],"autonomy,":[38],"and":[39,101,122],"hybrid":[41],"approach":[42],"where":[43],"drafts":[45],"candidates":[46],"for":[47,128,163,174],"an":[48],"agentic":[49,107],"LLM":[50],"audit":[51,108],"to":[52,72,136],"accept":[53],"or":[54],"reject.":[55],"All":[56],"strategies":[57],"were":[58],"evaluated":[59],"on":[60],"19,801":[61],"MIMIC-IV":[62],"using":[64],"four":[65],"LLMs":[66,114,152],"spanning":[67],"compact":[68,113],"(Qwen2.5-3B-Instruct,":[69],"Llama-3.2-3B-Instruct,":[70,127],"Phi-4-mini-instruct)":[71],"large-scale":[73],"(Sonnet-4.5).":[74],"Precision":[75],"guided":[76],"evaluation":[77],"still":[80],"supply":[81],"any":[82],"missing":[83],"diagnoses.":[84],"alone":[86],"reached":[87],"55.8%":[88],"precision":[89],"always":[91],"surfacing":[92],"suggestions.":[94],"lagged":[97],"severely":[98],"(1.5\u201334.6%":[99],"precision)":[100],"produced":[102],"inconsistent":[103],"output":[104],"sizes.":[105],"The":[106],"delivered":[109],"the":[110,116],"best":[111],"trade-off:":[112],"reviewed":[115],"candidates,":[118],"discarded":[119],"weak":[120],"evidence,":[121],"returned":[123],"2\u20138":[124],"high-confidence":[125],"codes.":[126],"example,":[129],"improved":[130],"1.5%":[132],"generator":[135],"55.1%":[137],"verifier":[140],"trimming":[142],"false":[143],"positives":[144],"by":[145],"73%.":[146],"These":[147],"results":[148],"show":[149],"that":[150],"positioning":[151],"quality":[154],"controllers,":[155],"rather":[156],"than":[157],"primary":[158],"generators,":[159],"yields":[160],"reliable":[161],"support":[162],"teams,":[166],"formal":[168],"recall/F1":[169],"reporting":[170],"future":[172],"work":[173],"fully":[175],"autonomous":[176],"implementations.":[177]},"counts_by_year":[],"updated_date":"2026-03-30T08:08:38.191290","created_date":"2026-03-05T00:00:00"}