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Codametrix Autonomous Medical Coding Platform

Codametrix Autonomous Medical Coding Platform

Codametrix Autonomous Medical Coding Platform

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Codametrix Autonomous Medical Coding Platform
Codametrix Autonomous Medical Coding Platform

Overview


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Avia Summary

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Codametrix Autonomous Medical Coding Platform is a solution provided by CodaMetrix, Inc.. It belongs to multiple categories of digital health solutions including Revenue Cycle Management (RCM) and Coding & Documentation.
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It has 11 verified clients.
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Codametrix Autonomous Medical Coding Platform integrates with major EMRs such as Epic, Cerner, and Other.
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Some other resource(s) that may be helpful in learning about Codametrix Autonomous Medical Coding Platform include: Unlocking the true potential of healthcare RCM: How a digital front door makes all the difference and Top Revenue Cycle Management (RCM) Companies Report | Fall 2024
DESCRIPTION

CodaMetrix is a SaaS platform, hosted in the AWS Cloud environment, that uses AI and ML to interpret structured and unstructured clinical data from the Electronic Health Record (EHR) to reduce time and cost of coding while increasing the quality of claims data. It works in parallel with existing coding processes, automatically capturing chargeable billing codes and providing medical coding teams with context and suggestions for codes that require further review.

CodaMetrix currently supports Epic, GE, Meditech, and Cerner and can be expanded to other EHRs. It is available in a growing number of service lines including Radiology, Pathology, Endoscopy, Surgery, and Evaluation & Management. CMX Insights™ delivers real-time visibility into coding performance, financial impact, and compliance risks—empowering health systems to optimize operations, reduce denials, and drive continuous improvement.

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Product capabilities

Intelligent Automation

The CodaMetrix platform leverages advanced machine learning and the latest in AI to translate clinical notes into accurate, compliant billing and diagnostic codes—automatically applying them across service lines without introducing new workflows. By ensuring coding is complete, timely, and reflective of the full specificity of each patient encounter and provider note, CodaMetrix helps organizations capture appropriate reimbursement and reduce revenue leakage. Real-time compliance monitoring and continuous auditing against the latest payer guidelines further safeguard accuracy and minimize audit risk—delivering high-quality, intelligent automation that adapts as the healthcare landscape evolves.

AVIA GUIDE
What is intelligent automation?
Utilizes AI and machine learning to automate routine tasks Employs robotic process automation (RPA) for repetitive, rule-based processes Reduces manual data entry and associated errors Example: An RCM solution that automatically codes encounters based on clinical documentation and updates claims in real-time.
Capability Comparison Grid

Codametrix Autonomous Medical Coding Platform

Codametrix Autonomous Medical Coding Platform

Intelligent Automation
Advanced Analytics and Reporting
Compliance and Security
Denial Management and Prevention
EHR integration

Acute care EMR, Ambulatory EMR, Ancillary EMR, Pop health platform, ADT, Access +/or revenue cycle
Use case dependent
Epic, Cerner, Other, Meditech, athena, Athenahealth, GE
Mobile / Tablet (web optimized), Desktop
Use cases and differentiators

CodaMetrix provides autonomous coding services for the following specialties for both inpatient and outpatient scenarios:

  • Diagnostic Radiology
  • Interventional Radiology
  • Anatomic Pathology
  • GI and Special Procedures
  • Surgery
  • Bedside Professional Visits

Yes, CodaMetrix is currently contracted with Children's Health Systems. 

The primary users of the CodaMetrix platform are designated Medical Coders, who engage with the system to review, validate, and oversee coding outcomes. A core goal of the platform is to relieve physicians of medical coding tasks and reduce administrative burden—enabling them to focus on patient care. In addition, revenue cycle and health system leadership use CMX Insights™ to gain real-time visibility into coding automation, accuracy, financial performance, and compliance. These insights support strategic decision-making, operational efficiency, and long-term revenue integrity across the organization.

  • Codametrix offers fully autonomous coding vs. computer assisted coding (suggested code sets) 
  • Professional coder productivity reporting
  • Ease of performing QA and auditing with Coding Manager tools for self service coding QA (including building in custom rules and sampling)
  • Built by Providers, for Providers: Developed out of Mass General Brigham, CodaMetrix is trained on real, clinically validated data—not synthetic datasets—ensuring high accuracy tailored to the complexity of large health systems.

  • Complete Clinical Context: Our platform ingests both structured and unstructured data to build a longitudinal patient record, enabling smarter, more accurate coding across specialties like radiology, pathology, surgery, and E/M.

  • Human-in-the-Loop Automation: With CMX Amplify™, coders receive real-time feedback and decision support, improving productivity, accuracy, and audit readiness through a continuous learning loop.

  • Accuracy That Reflects Reality: CodaMetrix delivers 96%+ automation accuracy across all eligible automated cases—not just ideal scenarios—driving better reimbursement, compliance, and performance.

  • Actionable Analytics: CMX Insights™ provides real-time visibility into automation, financial impact, and denial trends, helping leaders make data-driven decisions.

  • Provider-Owned & Epic-Proven: As a provider-owned company and trusted Epic Toolbox member, we bring deep expertise in seamless EHR integration and scalable results.
Health Equity

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Downloads

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CodaMetrix_WP_Future-Proofing-Medical-Coding.pdf
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CodaMetrix_OHSU_CaseStudy.pdf
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CodaMetrix_UMassMemorial_CaseStudy.pdf
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CodaMetrix_UMiami-Case-Study.pdf

Reviews


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Reviewer’s Role
  • End user
  • Project manager
  • IT / Technical support
  • Executive sponsor
  • Internal consultant
  • Other

Reviewer’s Org Size
  • XL ($5B+ NPR)
  • L ($3-5B NPR)
  • M ($1-3B NPR)
  • S ($0.2-1B NPR)
  • XS (< $0.2B NPR)

Reviewer’s Org EMR compatibility

Reviewer’s Org Type
  • AMC
  • Pediatric Facilities
  • ACO
  • Rural Presence

March 27, 2025

verified

March 27, 2025

There’s hope we will reach about 70 percent of our pathology volume in the next year.

“CodaMetrix sends back reports to us with the codes, or it sends back a report of what it knows it can't code, so the human coders then attack those and code them manually. There’s hope we will reach about 70 percent of our pathology volume in the next year. And we do believe there are other opportunities. We are exploring autonomous coding for a variety of specialties.” 

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David S. Mendelson

Vice Chair for Radiology Information Technology , Vice chair for radiology information technology working with Codametrix Autonomous Medical Coding Platform at Mount Sinai Hospital
Review Source
:
codametrix.com/
Helpful(0)

March 27, 2025

verified

March 27, 2025

Our automation rate has increased by 15% since go-live, now reaching 86%

“Since integrating CodaMetrix’s platform into our RCM system in 2022, we have eliminated our historical coding backlog and reduced coder overtime. The improvements have been significant—our automation rate has increased by 15% since go-live, now reaching 86% and exceeding internal goals. The use of AI to automate coding through CodaMetrix’s platform has streamlined our coding processes and enhanced clinical detail, ultimately contributing to better results. We’re exploring expansion into additional service lines within our health system.” 

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Barbara Scully

Associate Vice President of Physician Billing, Associate vice president of physician billing working with Codametrix Autonomous Medical Coding Platform at UMass Memorial Medical Center
Review Source
:
codametrix.com/
Helpful(0)

November 13, 2024

verified

November 13, 2024

Would have taken a full FTE a year to code what it has mastered

Our turnaround time is dramatically different with the assistance of CMX: 4.82 days versus 43.6. CMX has also coded enough work that it would have taken a full FTE an entire year to complete. Not having anxiety around these backlogs is game-changing. Our coders were burning out from the amount of overtime required. They were open to adopting this technology because they recognized that the status quo was unsustainable. The success we saw with autonomous coding in radiology encouraged me to expand automation efforts to other service lines as well.

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Tammy Bickle

Director, Revenue Cycle, Executive sponsor working with Codametrix Autonomous Medical Coding Platform at OHSU Hospital
Helpful(0)

November 13, 2024

verified

November 13, 2024

Grateful for their support, reduced our expenses

"We had an extremely successful go live and optimization project thanks to the talented and knowledgeable team at CodaMetrix. We are grateful for their support in helping us exceed our automation goal and we are excited to expand the use of this platform to other service lines. This implementation has reduced our expenses and allowed our coders to focus on those accounts that require human intervention to ensure accuracy and compliance."

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Robin Smith

Executive Director, Health System , Executive sponsor working with Codametrix Autonomous Medical Coding Platform at University of Miami Health System
Review Source
:
codametrix.com/
Helpful(0)

November 13, 2024

verified

November 13, 2024

Unprecedented levels of automation

Through the adoption of CodaMetrix we have been able to reach unprecedented levels of automation that have had efficiency & cost reduction ripple effect across our entire organization.

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Kim Davis

Sr. Director, Revenue Services, Executive sponsor working with Codametrix Autonomous Medical Coding Platform at University of Colorado Medicine
Review Source
:
codametrix.com/
Helpful(0)

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