KREL: Automatic Medical Coding via Knowledge-Guided Reasoning over Clinical Evidence with LLMs

TL;DR - KREL is an LLM-based framework for automatically assigning ICD codes to clinical notes by combining clinical-evidence reasoning with structured coding guidelines. This knowledge-guided approach aims to reduce hallucinations, improve standards compliance, and handle challenges such as long notes and a large label space.

• Integrates external ICD coding guidelines directly into the LLM reasoning process.
• Couples clinical-text interpretation with evidence-based, multi-step code selection.
• Addresses limitations of extreme multi-label classification and unconstrained generative approaches.
• Consistently outperforms strong pretrained language model and state-of-the-art LLM baselines on benchmark datasets.