Clinical coding that stays inside the classification

Manual code navigation in the Code Navigator, live DRG grouping, and Code Captain, an AI autocoder that follows the classification step by step: search the index, follow the cross-references, verify in the tables. Every code it keeps traces back to the document and the sentence it came from. These screens show coding in ICD-10-AM and ACHI grouping to AR-DRG, on the V11.0 grouper certified by IHACPA; ICD-10-CM and ICD-10-PCS grouping to MS-DRG are live for coding in the United States books.

Just need the coding screen, without the rest of HealthOS? Code Navigator and Code Captain are the same coding screens on their own, by monthly subscription.

Code Captain preparing a document for a patient not in HealthOS: name, date of birth, Medicare, phone and record number removed in the browser before anything is sent, with a toggle between the redacted text that is sent and the original that stays.

From the record to the claim

Manual coding

Index search first, then code table verification, as the coding standards require.

Code Captain

The AI autocoder: it navigates the classification and refuses any code it can’t prove.

Live DRG

The grouping updates with every code, so a grouping error shows before the episode is finalised.

Into the claim

A finalised code set and DRG move to the claiming queue with no re-keying.

What it does

Code with the classification open, and show your working

Manual coding

Search the index, verify in the tables

Type a term such as “cellulitis” and the Code Navigator searches the classification index, showing lead terms, modifiers and cross-references as they appear in print. Follow a reference into the tables, drill to the character level the code needs, and read inclusions, exclusions and coding notes inline.

Diagnosis and procedure codes in the same interface
Procedure codes found in the index and verified in the Tabular List, with inclusions and exclusions inline
Hospital-acquired complications flagged against the national list, with the condition onset to confirm
The coding standards a code cites, the codes they direct, and the codes they forbid, with national and state advice in the jurisdiction that applies
Every assignment timestamped and attributed in the coding timeline

Finding an ACHI procedure in the Code Navigator’s Code Search: the intervention’s entry in the Tabular List with its inclusions and exclusions, ready to assign.

AR-DRG Version 11.0 grouper, under IHACPA’s Certificate of Acceptance

Live DRG as you code

As codes are added the grouper runs and returns the Diagnosis Related Group. The result updates with every change, so an error DRG or an ungroupable episode is visible while the record is still open.

The Code Navigator coding an episode: an ICD-10-AM principal and two additional diagnoses, an ACHI procedure, and the live AR-DRG V11.0 with its cost weight.

Code Captain Alpha preview

An agent that follows the classification, step by step

Code Captain reads the clinical record for an episode: discharge summaries, progress notes, procedure reports and pathology. For each condition or procedure it searches the code index, follows every cross-reference, then verifies the candidate in the code tables. A code it can’t trace through the index and the tables is dropped. Codes are not taken from the model’s memory. It codes the full picture: a neoplasm’s morphology with its site, and the external cause of a poisoning or injury. It applies the coding standards for the episode, and flags a diagnosis on the hospital-acquired-complications list for the coder to confirm.

A pre-admission pass codes only from what was on file before the patient arrived
A post-discharge pass codes from the full episode record
Each pass is independent and produces its own traceable result

Every code traces back to its source

Each code shows the document, the sentence and the classification path behind it: the search term, the index result, the cross-reference and the tabular check. Patient identifiers are removed before any text goes to the model, and the screen shows what was removed and what was sent.

How Code Captain reached a code: its reasoning, each look-up in the Alphabetic Index and each read of the Tabular List, then the code it proposed.

The coder decides

Code Captain’s output is a draft. The coder reviews each code, then accepts, changes or rejects it, and the grouper re-runs on the accepted set. Every run is logged: which model, which documents were read, which codes were proposed and accepted, and the final grouping. Your organisation chooses the model that powers it, separately from other AI features.

Eclipse in NOI testing

Coding feeds the claim

An episode with a finalised code set and a DRG appears in the claiming queue, ready for Medicare, DVA or private health insurance submission, with no re-keying between the coding screen and the claim.