COOKED
The core work — reading clinical documentation and assigning ICD-10-CM/PCS, CPT and DRG codes, abstracting charts into registries, scrubbing claims, and checking records for completeness — is text-in/label-out pattern work that computer-assisted coding plus LLMs already do at production quality, with humans increasingly auditing rather than coding. What persists is the ambiguous 10%: complex inpatient DRG assignment, clinical documentation improvement queries to physicians, denial and appeal narratives, and release-of-information decisions where HIPAA exposure attaches to a named person. Credentials (RHIT, CCS, CPC) are employer-required and payer-relevant but are not state licensure, so the regulatory shield is thin.
Core tasks are already automatable. Assigning ICD-10-CM codes from a discharge summary, abstracting tumor-registry fields, and running claim scrubbers are all structured text-to-label mappings that CAC engines already pre-code at 80-90% accuracy on outpatient charts, leaving the coder as a confirm-or-override reviewer; the 5 rather than 0 reflects that multi-comorbidity inpatient DRG sequencing and querying an attending for specificity on 'sepsis vs. bacteremia' still require reading the whole chart against Coding Clinic guidance.
Fully desk- and screen-based. The job is a workstation, an EHR, an encoder, and increasingly a home office — the only physical residue is pulling or scanning legacy paper charts, purging shadow files, and walking a release request to a department, which is why this sits at 3 rather than 0.
Certification preferred, not legally required. RHIT, CCS and CPC are AHIMA/AAPC certifications that employers and payers demand but no state licenses you, so nothing legally requires a credentialed human to touch a claim; the 6 reflects that upcoding exposes you personally under the False Claims Act and improper disclosure names you in a HIPAA breach report, which is real accountability without the practice-act protection a nurse or RT gets.
Anonymous artifact production. Patients requesting their records and physicians receiving CDI queries deal with the HIM department, not with you by name, and payers see only a claim form — the 4 credits the working relationships you build with specific attendings who learn to answer your queries, but any competent replacement inherits that in a month.
Meaningful discretion. Choosing a principal diagnosis when two conditions both meet 'after study,' deciding whether a subpoena is valid enough to release psychotherapy notes, and writing an appeal that reframes medical necessity are genuine calls made against official guidelines rather than invented from scratch, which puts this at the low end of real discretion — the coding rules exist, you're interpreting them, and a compliance auditor reviews you.
Health New Zealand is reported to have implemented AI scribe tools in hospitals to document clinical consultations.
Has AI actually changed your work?