@inproceedings{xu-etal-2026-travel,
    title = "Travel on the {ICD} Tree: Benchmarking Agentic Reasoning for {ICD} Coding from {C}hinese Electronic Medical Records",
    author = "Xu, Xinjie  and
      Fan, Yongqi  and
      Chen, Shuang-shuang  and
      Ye, Qi  and
      Guo, Weibin  and
      Hu, Xinxuan",
    editor = "Liakata, Maria  and
      Moreira, Viviane P.  and
      Zhang, Jiajun  and
      Jurgens, David",
    booktitle = "Findings of the {A}ssociation for {C}omputational {L}inguistics: {ACL} 2026",
    month = jul,
    year = "2026",
    address = "San Diego, California, United States",
    publisher = "Association for Computational Linguistics",
    url = "https://preview.aclanthology.org/ingest-acl/2026.findings-acl.191/",
    pages = "3927--3943",
    ISBN = "979-8-89176-395-1",
    abstract = "Accurate International Classification of Diseases (ICD) coding is crucial for hospital management and healthcare data governance. In clinical practice, straightforward cases can often be matched directly to ICD codes via diagnostic text, establishing retrieval-based methods as the baseline. More advanced approaches leverage large language models to rerank these results. However, real-world coding scenarios are typically more complex, demanding reasoning that goes beyond superficial descriptions. For instance, it involves synthesizing key information such as disease subtype, anatomical location, and complications from complex progress notes to accurately identify the primary diagnosis. However, a comprehensive evaluation framework for ICD coding based on complete EMRs is still lacking. To address these challenges, we constructed the Code4Detail dataset, which comprises 560 real clinical records covering 434 common diseases across 19 core chapters of ICD-10. To systematically explore the capability boundaries of large language models under different paradigms, we further propose the Travel on the ICD Tree (ToT-ICD) evaluation framework. Unlike the conventional retrieval-recall approach, ToT-ICD treats ICD coding as a structured exploration process across a hierarchical taxonomy. We design an agentic workflow that integrates similarity retrieval, path-guided navigation, and dynamic backtracking, enabling logical reasoning and decision-making under coding rules."
}