Beyond ICD Codes: Semantic IDs for Generative Medical Coding

arXiv cs.AIOctober 15, 2026en

arXiv cs.AI

AI Global Wire

arXiv:2610.19301v1 Announce Type: new Abstract: Generative approaches to automatic International Classification of Diseases (ICD) coding use large language models (LLMs) to predict ICD codes from clinical documents. However, original ICD code strings are not ideal generation targets because the ICD hierarchy does not always reflect clinical relationships, and LLMs struggle to interpret and generate these codes. We introduce SemICD, a framework that trains LLMs to generate Semantic IDs (SIDs) instead. SemICD constructs SIDs by hierarchically clustering embeddings of textual code profiles, allowing semantically related codes to share prefixes while each complete SID uniquely identifies one ICD

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