We present **CPTCoder**, a human-in-the-loop system that predicts standardized medical procedure codes from clinical text. Clinical procedure coding is an extreme multi-label classification problem over a long-tailed space of short numeric identifiers, where a single-digit difference denotes an entirely different procedure. CPTCoder adapts an instruction-tuned LLM with a code-aware vocabulary and constrained decoding that guarantees all outputs are valid codes. To support human review, we derive per-code posterior inclusion probabilities from n-best reweighting, producing interpretable confidence scores that rank predictions and flag uncertain cases. A post-decoding constraint repair step enforces mutual-exclusion rules between conflicting codes. To enable reproducible research in this underexplored setting, we release **MIMIC-CPT**, a PhysioNet-accessible benchmark of 37,885 expert-cleaned report–code pairs with a deliberately hardened test split: 88% of test examples contain label combinations unseen during training, and over a third include codes with five or fewer training occurrences. We additionally provide 413,085 weakly aligned pairs and evaluate on a separate live dataset from a hospital, which includes out-of-domain radiology reports with billing-expert-verified labels. CPTCoder achieves 0.61 and 0.51 micro-F1 on the hardened MIMIC split and Hospital-298 respectively, outperforming the strongest baseline by 12 and 5 absolute points while reducing digit-level near-miss errors.

The learning process for medical residents presents significant challenges, demanding both the ability to interpret complex case reports and the rapid acquisition of accurate medical knowledge from reliable sources. Residents typically study case reports and engage in discussions with peers and mentors, but finding relevant educational materials and evidence to support their learning from these cases is often time-consuming and challenging. To address this, we introduce MedTutor, a novel system designed to augment resident training by automatically generating evidence-based educational content and multiple-choice questions from clinical case reports. MedTutor leverages a Retrieval-Augmented Generation (RAG) pipeline that takes clinical case reports as input and produces targeted educational materials. The system’s architecture features a hybrid retrieval mechanism that synergistically queries a local knowledge base of medical textbooks and academic literature (using PubMed, Semantic Scholar APIs) for latest related research, ensuring the generated content is both foundationally sound and current. The retrieved evidence is filtered and ordered using a state-of-the-art reranking model and then an LLM generates the final long-form output describing the main educational content regarding the case-report.We conduct a rigorous evaluation of the system. First, two radiologists assessed the quality of outputs, finding them to be of high clinical and educational value. Second, we perform a large-scale evaluation using an LLM-as-a Judge to understand if LLMs can be used to evaluate the output of the system. Our analysis using correlation of LLMs with human expert judgments reveals a moderate alignment and highlights the continued necessity of expert oversight.

Text simplification has emerged as an increasingly useful application of AI for bridging the communication gap in specialized fields such as medicine, where the lexicon is often dominated by technical jargon and complex constructs. Despite notable progress, methods in medical simplification sometimes result in the generated text having lower quality and diversity. In this work, we explore ways to further improve the readability of text simplification in the medical domain. We propose (1) a new unlikelihood loss that encourages generation of simpler terms and (2) a reranked beam search decoding method that optimizes for simplicity, which achieve better performance on readability metrics on three datasets. This study’s findings offer promising avenues for improving text simplification in the medical field.