# MedDCR: Learning to Design Agentic Workflows for Medical Coding

arXiv: https://arxiv.org/abs/2511.13361 · HTML: https://mlsanity.com/paper/2511.13361/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 33 of its 82 references that are in the map.
- First posted on arXiv 17 Nov 2025.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 30 of 33)

- [Judging LLM-as-a-Judge with MT-Bench and Chatbot Arena](https://mlsanity.com/paper/2306.05685/) (2023)
- [Self-Consistency Improves Chain of Thought Reasoning in Language Models](https://mlsanity.com/paper/2203.11171/) (2022)
- [Toolformer: Language Models Can Teach Themselves to Use Tools](https://mlsanity.com/paper/2302.04761/) (2023)
- [ToolLLM: Facilitating Large Language Models to Master 16000+ Real-world APIs](https://mlsanity.com/paper/2307.16789/) (2023)
- [Improving Factuality and Reasoning in Language Models through Multiagent Debate](https://mlsanity.com/paper/2305.14325/) (2023)
- [CAMEL: Communicative Agents for "Mind" Exploration of Large Language Model Society](https://mlsanity.com/paper/2303.17760/) (2023)
- [Encouraging Divergent Thinking in Large Language Models through Multi-Agent Debate](https://mlsanity.com/paper/2305.19118/) (2023)
- [Automatic Prompt Optimization with "Gradient Descent" and Beam Search](https://mlsanity.com/paper/2305.03495/) (2023)
- [Promptbreeder: Self-Referential Self-Improvement Via Prompt Evolution](https://mlsanity.com/paper/2309.16797/) (2023)
- [Ghost in the Minecraft: Generally Capable Agents for Open-World Environments via Large Language Models with Text-based Knowledge and Memory](https://mlsanity.com/paper/2305.17144/) (2023)
- [Explainable Prediction of Medical Codes from Clinical Text](https://mlsanity.com/paper/1802.05695/) (2018)
- [Is Self-Repair a Silver Bullet for Code Generation?](https://mlsanity.com/paper/2306.09896/) (2023)
- [Multi-agent Architecture Search via Agentic Supernet](https://mlsanity.com/paper/2502.04180/) (2025)
- [ACI-BENCH: a Novel Ambient Clinical Intelligence Dataset for Benchmarking Automatic Visit Note Generation](https://mlsanity.com/paper/2306.02022/) (2023)
- [Multi-Agent Design: Optimizing Agents with Better Prompts and Topologies](https://mlsanity.com/paper/2502.02533/) (2025)
- [ICD Coding from Clinical Text Using Multi-Filter Residual Convolutional Neural Network](https://mlsanity.com/paper/1912.00862/) (2019)
- [Repair Is Nearly Generation: Multilingual Program Repair with LLMs](https://mlsanity.com/paper/2208.11640/) (2022)
- [Code Synonyms Do Matter: Multiple Synonyms Matching Network for Automatic ICD Coding](https://mlsanity.com/paper/2203.01515/) (2022)
- [Self-Verification Improves Few-Shot Clinical Information Extraction](https://mlsanity.com/paper/2306.00024/) (2023)
- [A Label Attention Model for ICD Coding from Clinical Text](https://mlsanity.com/paper/2007.06351/) (2020)
- [Towards Open-Set Object Detection and Discovery](https://mlsanity.com/paper/2204.05604/) (2022)
- [Explainable Automated Coding of Clinical Notes using Hierarchical Label-wise Attention Networks and Label Embedding Initialisation](https://mlsanity.com/paper/2010.15728/) (2020)
- [Automated Clinical Coding: What, Why, and Where We Are?](https://mlsanity.com/paper/2203.11092/) (2022)
- [A Unified Review of Deep Learning for Automated Medical Coding](https://mlsanity.com/paper/2201.02797/) (2022)
- [MDACE: MIMIC Documents Annotated with Code Evidence](https://mlsanity.com/paper/2307.03859/) (2023)
- [Multi-label Few-shot ICD Coding as Autoregressive Generation with Prompt](https://mlsanity.com/paper/2211.13813/) (2022)
- [Exploring LLM Multi-Agents for ICD Coding](https://mlsanity.com/paper/2406.15363/) (2024)
- [Can GPT-3.5 Generate and Code Discharge Summaries?](https://mlsanity.com/paper/2401.13512/) (2024)
- [An Unsupervised Approach to Achieve Supervised-Level Explainability in Healthcare Records](https://mlsanity.com/paper/2406.08958/) (2024)
- [MedCodER: A Generative AI Assistant for Medical Coding](https://mlsanity.com/paper/2409.15368/) (2024)

## Built on by (most cited first, 3 of 3)

- [Symphony for Medical Coding: A Next-Generation Agentic System for Scalable and Explainable Medical Coding](https://mlsanity.com/paper/2603.29709/) (2026)
- [KREL: Automatic Medical Coding via Knowledge-Guided Reasoning over Clinical Evidence with LLMs](https://mlsanity.com/paper/2608.20887/) (2026)
- [LearnActCoder: Role-Aware Error Memory for Adaptive Clinical Coding Agents](https://mlsanity.com/paper/2609.19721/) (2026)

## Abstract (arXiv)

Medical coding converts free-text clinical notes into standardized diagnostic and procedural codes, which are essential for billing, hospital operations, and medical research. Unlike ordinary text classification, it requires multi-step reasoning: extracting diagnostic concepts, applying guideline constraints, mapping to hierarchical codebooks, and ensuring cross-document consistency. Recent advances leverage agentic LLMs, but most rely on rigid, manually crafted workflows that fail to capture the nuance and variability of real-world documentation, leaving open the question of how to systematically learn effective workflows. We present MedDCR, a closed-loop framework that treats workflow design as a learning problem. A Designer proposes workflows, a Coder executes them, and a Reflector evaluates predictions and provides constructive feedback, while a memory archive preserves prior designs for reuse and iterative refinement. On benchmark datasets, MedDCR outperforms state-of-the-art baselines and produces interpretable, adaptable workflows that better reflect real coding practice, improving both the reliability and trustworthiness of automated systems.