Paper
From Documents to Spans: Code-Centric Learning for LLM-based ICD Coding
Authors
Xu Zhang, Wenxin Ma, Chenxu Wu, Rongsheng Wang, Kun Zhang, S. Kevin Zhou
Abstract
ICD coding is a critical yet challenging task in healthcare. Recently, LLM-based methods demonstrate stronger generalization than discriminative methods in ICD coding. However, fine-tuning LLMs for ICD coding faces three major challenges. First, existing public ICD coding datasets provide limited coverage of the ICD code space, restricting a model's ability to generalize to unseen codes. Second, naive fine-tuning diminishes the interpretability of LLMs, as few public datasets contain explicit supporting evidence for assigned codes. Third, ICD coding typically involves long clinical documents, making fine-tuning LLMs computationally expensive. To address these issues, we propose Code-Centric Learning, a training framework that shifts supervision from full clinical documents to scalable, short evidence spans. The key idea of this framework is that span-level learning improves LLMs' ability to perform document-level ICD coding. Our proposed framework consists of a mixed training strategy and code-centric data expansion, which substantially reduces training cost, improves accuracy on unseen ICD codes and preserves interpretability. Under the same LLM backbone, our method substantially outperforms strong baselines. Notably, our method enables small-scale LLMs to achieve performance comparable to much larger proprietary models, demonstrating its effectiveness and potential for fully automated ICD coding.
Metadata
Related papers
Vibe Coding XR: Accelerating AI + XR Prototyping with XR Blocks and Gemini
Ruofei Du, Benjamin Hersh, David Li, Nels Numan, Xun Qian, Yanhe Chen, Zhongy... • 2026-03-25
Comparing Developer and LLM Biases in Code Evaluation
Aditya Mittal, Ryan Shar, Zichu Wu, Shyam Agarwal, Tongshuang Wu, Chris Donah... • 2026-03-25
The Stochastic Gap: A Markovian Framework for Pre-Deployment Reliability and Oversight-Cost Auditing in Agentic Artificial Intelligence
Biplab Pal, Santanu Bhattacharya • 2026-03-25
Retrieval Improvements Do Not Guarantee Better Answers: A Study of RAG for AI Policy QA
Saahil Mathur, Ryan David Rittner, Vedant Ajit Thakur, Daniel Stuart Schiff, ... • 2026-03-25
MARCH: Multi-Agent Reinforced Self-Check for LLM Hallucination
Zhuo Li, Yupeng Zhang, Pengyu Cheng, Jiajun Song, Mengyu Zhou, Hao Li, Shujie... • 2026-03-25
Raw Data (Debug)
{
"raw_xml": "<entry>\n <id>http://arxiv.org/abs/2603.15270v1</id>\n <title>From Documents to Spans: Code-Centric Learning for LLM-based ICD Coding</title>\n <updated>2026-03-16T13:37:01Z</updated>\n <link href='https://arxiv.org/abs/2603.15270v1' rel='alternate' type='text/html'/>\n <link href='https://arxiv.org/pdf/2603.15270v1' rel='related' title='pdf' type='application/pdf'/>\n <summary>ICD coding is a critical yet challenging task in healthcare. Recently, LLM-based methods demonstrate stronger generalization than discriminative methods in ICD coding. However, fine-tuning LLMs for ICD coding faces three major challenges. First, existing public ICD coding datasets provide limited coverage of the ICD code space, restricting a model's ability to generalize to unseen codes. Second, naive fine-tuning diminishes the interpretability of LLMs, as few public datasets contain explicit supporting evidence for assigned codes. Third, ICD coding typically involves long clinical documents, making fine-tuning LLMs computationally expensive. To address these issues, we propose Code-Centric Learning, a training framework that shifts supervision from full clinical documents to scalable, short evidence spans. The key idea of this framework is that span-level learning improves LLMs' ability to perform document-level ICD coding. Our proposed framework consists of a mixed training strategy and code-centric data expansion, which substantially reduces training cost, improves accuracy on unseen ICD codes and preserves interpretability. Under the same LLM backbone, our method substantially outperforms strong baselines. Notably, our method enables small-scale LLMs to achieve performance comparable to much larger proprietary models, demonstrating its effectiveness and potential for fully automated ICD coding.</summary>\n <category scheme='http://arxiv.org/schemas/atom' term='cs.CL'/>\n <category scheme='http://arxiv.org/schemas/atom' term='cs.AI'/>\n <published>2026-03-16T13:37:01Z</published>\n <arxiv:primary_category term='cs.CL'/>\n <author>\n <name>Xu Zhang</name>\n </author>\n <author>\n <name>Wenxin Ma</name>\n </author>\n <author>\n <name>Chenxu Wu</name>\n </author>\n <author>\n <name>Rongsheng Wang</name>\n </author>\n <author>\n <name>Kun Zhang</name>\n </author>\n <author>\n <name>S. Kevin Zhou</name>\n </author>\n </entry>"
}