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RESEARCH · RESEARCH · #586

LearnActCoder (Learn-Then-Act): role-aware error memory boosts CPT coding F1 on MIMIC-III

arXiv:2609.19721v1 introduces Learn‑Then‑Act, an inference‑time adaptation framework that converts a small labeled LEARN batch into a structured Mistake Knowledge Database (MistakeKDB) and routes lessons to a recall‑oriented Coder or precision‑oriented Judge. Instantiated as LearnActCoder with lookup grounding, the method raises CPT/HCPCS F1 by 5.9 percentage points on 150 matched MIMIC‑III notes, shifts ICD‑10 coding toward higher precision on a MIMIC‑IV cohort (with recall loss), and preserves a stable ICD operating point on 1,000 held‑out MIMIC‑III notes; ICD‑9/ICD‑10 F1 changes are mixed and overall CPT/HCPCS absolute performance remains low; evaluation is retrospective.

KEY POINTS

  1. arXiv:2609.19721v1 introduces Learn‑Then‑Act, an inference‑time adaptation framework that converts a small labeled LEARN batch into a structured Mistake Knowledge Database (MistakeKDB) and routes lessons to a recall‑oriented Coder or precision‑oriented Judge.
  2. Instantiated as LearnActCoder with lookup grounding, the method raises CPT/HCPCS F1 by 5.9 percentage points on 150 matched MIMIC‑III notes, shifts ICD‑10 coding toward higher precision on a MIMIC‑IV cohort (with recall loss), and preserves a stable ICD operating point on 1,000 held‑out MIMIC‑III notes; ICD‑9/ICD‑10 F1 changes are mixed and overall CPT/HCPCS absolute performance remains low; evaluation is retrospective.
  3. Demonstrates that a structured, role‑aware error memory applied at inference time can adapt clinical coding behavior and improve CPT coding metrics without model retraining or workflow changes.

WHY IT MATTERS

Demonstrates that a structured, role‑aware error memory applied at inference time can adapt clinical coding behavior and improve CPT coding metrics without model retraining or workflow changes.

SOURCES & TIMELINE

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