Cleveland Clinic’s AI Coding Move and What It Means for Medical Coders – Insights from Dr. Santosh Guptha, Medesun
Cleveland Clinic partnered with Akasa to deploy AI tools within mid-revenue cycle workflows, where patient care documentation is translated into standardized medical codes for:
Billing
Reporting
Continuity of care
According to system leadership:
Coders may review 100+ clinical documents per encounter
They choose from more than 140,000 ICD-10, CPT, and HCPCS codes
Manual coding can take up to one hour per case
The AI solution helps:
Automate routine, repetitive coding tasks
Identify which steps can be automated
Flag cases that require human judgment and clinical reasoning
Early results showed improved speed and accuracy, smoother prior authorizations, fewer delays in care, and a better patient experience.
The Key Insight: AI Does Not Replace Coders — It Redefines Them
What Cleveland Clinic clearly demonstrated is this:
AI handles volume and repetition. Humans handle judgment, compliance, and accountability.
AI can:
Scan documentation faster
Suggest codes
Detect patterns
But AI cannot:
Interpret nuanced clinical intent
Resolve documentation gaps
Defend coding decisions during audits
Apply payer-specific rules intelligently
Understand compliance risk the way a trained coder can
In fact, as AI becomes more powerful, coding errors become more visible, more traceable, and more costly.
This means healthcare organizations will rely more heavily on highly skilled coders, not fewer.
Why Medical Coders Must Upskill Now
With AI entering the coding workflow:
Coders are no longer just code selectors
They are becoming validators, auditors, and compliance experts
Coders must understand how AI thinks, where it fails, and how to correct it
Future-ready coders must be able to:
Review AI-suggested codes critically
Identify undercoding and overcoding risks
Ensure medical necessity is fully supported
Prevent AI-triggered denials and payer flags
Work alongside AI, not compete with it
This is where advanced AI-focused coding education becomes essential.
How CAIMC® from PMBAUSA LLC Prepares Coders for the AI Era
The CAIMC® – Certified AI Medical Coder, offered by PMBAUSA LLC, is designed specifically for this new reality.
CAIMC® does not teach coders to fear AI — it teaches them to master it.
What CAIMC® Focuses On
How AI and NLP are used in medical coding workflows
Where AI makes mistakes in ICD-10 and CPT selection
Human validation of AI-generated codes
Documentation improvement for AI-driven systems
Audit readiness in automated coding environments
Compliance, ethics, and accountability in AI-assisted coding
CAIMC® trains coders to become:
AI-aware coders
Audit-resilient professionals
Revenue-protecting specialists
Future-proof healthcare experts
Why CAIMC® Matters More Now Than Ever
As large health systems like Cleveland Clinic adopt AI:
Employers will prefer coders who understand AI logic
Coders without AI knowledge may struggle to stay relevant
Certification alone is not enough — AI literacy is critical
CAIMC® bridges the gap between:
Traditional medical coding
Advanced healthcare technology
Real-world revenue cycle operations
The Future Belongs to AI-Enabled Coders
AI is not eliminating medical coding — it is raising the bar.
Healthcare organizations want coders who can:
Work faster with AI
Think deeper than AI
Protect revenue where AI cannot
Ensure compliance in an automated world
Cleveland Clinic’s move confirms what the industry already knows:
The future of medical coding belongs to professionals who combine clinical knowledge, coding expertise, and AI intelligence.
With CAIMC® from PMBAUSA LLC, Medesun is proud to help medical coders step confidently into that future.
Dr. Santosh Kumar Guptha Trainer/Author
CCS-P, CCS , CPC, COC, CIC, CPC-P, CRC, CCC, CPCO, CANPC, CPB, CPMA, CEMC, CEDC, CIMC, CFPC, CUC, COBGC, CPCD, COSC, CPRC, CPEDC, CHONC, CENTC, CRHC, CGIC, CASCC, CGSC, CSFAC, CCVTC, RMC, RMA, CMBS, CMRS, CSCS, CSBB, FCR, FNR, FOR, CHA, CHL7, AHIMA Approved ICD-10 Trainer
Assuring the best services,
Medesun Healthcare Solutions
Reference – https://www.beckershospitalreview.com/healthcare-information-technology/ai/cleveland-clinic-taps-ai-to-streamline-medical-coding/
https://consultqd.clevelandclinic.org/ai-tools-boost-efficiency-patient-experience