BOSTON, June 8, 2026 – CodaMetrix, the market leader in autonomous medical coding, today announced the formation of its Coding Quality Council, an industry-first governance body made up of subject-matter experts and leaders from major health systems across the country. The Council's mission is to advance an objective framework for measuring medical coding quality and accuracy across the industry. Rooted in the coding standards, certification programs, and professional practices established by organizations such as AHIMA and AAPC, the framework provides a transparent and consistent approach to evaluating coding quality for both human and AI-generated coding.
Today, "95% accuracy" is widely cited as the gold standard in medical coding, but the industry has yet to agree on a consistent definition or measurement methodology for that number, and the benchmark means something different to every organization using it. The figure itself traces back to a CMS dollar-value standard never designed to measure code accuracy, and the two dominant audit methodologies, record-over-record and code-over-code, produce different results by design. In practice, coder agreement rates hover around 50% even among certified coders, which can influence how AI models are trained – and many vendors still claim 95%+ accuracy without transparent, standardized benchmarks. The industry lacks a common framework for objectively measuring coding quality and accuracy, making comparisons across organizations, coders, and AI systems difficult.
Moreover, multi-function AI platforms can now review a single patient record and generate multiple, differing codes without shared standards to govern them, making them difficult to compare, govern, and trust. As AI becomes more deeply embedded in clinical and revenue cycle workflows, the absence of shared definitions and measurement standards creates real risk, fueling payer-provider disputes, compliance gaps, and coding that fails to fully capture the complexity of a patient encounter.
"Medical coding sits at the center of clinical, financial, quality, and research workflows, yet the industry still lacks a consistent and objective way to measure coding quality and accuracy," said Hamid Tabatabaie, CEO of CodaMetrix. "As AI becomes increasingly embedded in healthcare, establishing a shared framework for evaluating coding decisions is essential to building trust, transparency, and accountability. The Coding Quality Council brings together health system leaders to help advance that objective standard for the industry."
The Coding Quality Council exists to bring consistency and trust to medical coding by advancing a shared, objective framework for measuring coding quality and accuracy. The framework keeps both human and AI-generated coding grounded in official coding guidelines while remaining responsive to evolving payer and regulatory requirements. The Council meets quarterly to review an objective coding quality framework that underpins CodaMetrix's autonomous coding platform, addressing emerging industry trends, methods for standardizing coding quality measures, and approaches to make coding decisions transparent and auditable. CodaMetrix leads the ongoing development and refinement of the framework, incorporating real-world insights from Council members to ensure it remains current and grounded in frontline coding practice.
Council members include:
"Instead of setting rules behind closed doors, CodaMetrix is rewriting how standards are created,” said Monica Watson, Corporate Coding Director at Allegheny Health Network. “By bringing health systems together around a common framework, we can preserve the necessary nuance between organizations without sacrificing consistency, transparency, or integrity. That collaboration is what will ultimately move the entire industry forward."
“Establishing a shared understanding of what high-quality medical coding looks like helps reduce friction throughout the revenue cycle,” said Tammy Bickle, Senior Director of Revenue Cycle at Oregon Health & Science University. “By aligning stakeholders around a common standard, CodaMetrix is highlighting one of the most significant, and often overlooked, challenges in revenue cycle management, while helping drive greater consistency and alignment across the industry.”
CodaMetrix partners with over 30 leading health systems across 27 states - collectively representing more than $191 billion in net patient revenue, 30 million patients, and 120,000 physicians - advancing autonomous coding through standardized industry benchmarks, governance frameworks, and a shared commitment to coding quality that the industry can trust.
CodaMetrix, rated #1 Best in KLAS in autonomous medical coding, is transforming revenue cycle operations through enterprise-grade AI automation. Built in partnership with providers representing more than 500 hospitals, including nine U.S. News & World Report Honor Roll institutions, CodaMetrix delivers scalable, end-to-end automation across specialties.
Its CMX CARE™ platform leverages clinical context to enable accurate, consistent, and autonomous coding at scale. CodaMetrix helps organizations reduce coding costs by more than 50%, cut manual coding by over 70%, and lower coding-related denials by up to 60%.
Learn more at www.codametrix.com or follow us on LinkedIn.
