Solutions / AI Medical Coding
AI Medical Coding
The coding engine: documentation in, payer-validated codes out, humans on the edge cases.
GetMax reads the encounter the way a coder does — the documentation, not just the headline diagnosis — then proposes ICD-10 and CPT codes and validates them against payer rules and NCCI edits before a claim is ever built. Certified coders review what the model flags as uncertain. Below, try the raw material: search any condition and watch codes resolve.
Start typing — ICD-10-CM codes resolve as you go.
Lookup powered by the NLM ICD-10-CM database — a taste of the raw material. The GetMax platform codes full encounters from documentation and validates against payer rules. Please don't enter patient information.
How the AI works
- 01
Read
The AI parses clinical documentation — diagnoses, procedures, laterality, specificity.
- 02
Code & validate
ICD-10/CPT proposed, then checked against payer policy and NCCI edits in real time.
- 03
Escalate the edges
Low-confidence encounters route to certified coders — nothing ships on model confidence alone.
Humans in the loop. By architecture.
Every AI decision is reviewable, and ambiguous encounters always reach a credentialed human coder. That's not a disclaimer — it's the architecture. Healthcare doesn't get automation without accountability.
Questions, answered
Is the demo above your production AI?+
No — it's an honest taste. The search runs on the NLM's public ICD-10-CM database. The GetMax platform codes full encounters from documentation and validates against payer rules, with certified coders in the loop.
What happens when the AI isn't sure?+
The encounter routes to a certified coder with the model's reasoning attached. Uncertainty is escalated, never guessed through.
Does this replace our coders?+
It replaces the repetitive volume, not the judgment. Coders shift from keying every encounter to reviewing the hard ones.
More of the engine:AI Claim Review,AI Documentation,AI Workflow Automation,Staff Augmentation,Business Process Outsourcing,Automation Services,GetMax RCM Platform,AI Coding Assistant,Denial Analytics,Practice Dashboard,Revenue Intelligence,Patient Eligibility Platform,Claims Management,Reporting & Analytics
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