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September 4, 2026·10 min read

The Convention That Beat Fine-Tuning at ICD-10 Coding

On a public outpatient benchmark with two-coder ICD-10-CM labels, the best open classifier scores micro-F1 0.34. A system that trains nothing on coding data scores 0.74, above every published result on the same notes. Most of the gain came from one convention, confirmed on a held-out split: code what the visit addressed, not everything the note documents.

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