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coding_cpt_generation produces the final CPT charges and coding suggestions for a visit. It is part of the Nanonets Coding Engine tool group. The CPT system prompt (payer-specific CPT rules, E/M MDM and time rules, psychotherapy rules, Spravato Buy & Bill handling, telehealth modifier rules, PA/chart-alert directives, and CCI/NCCI compliance instructions, ported from Fleming BuildSystemPrompt) is baked into the tool. Organization/user coding rules are appended at runtime.

Inputs

  • current_documentation (required): the encounter documentation to code. May wrap the target encounter in <current_encounter> tags.
  • encounter_metadata (optional): appointment type, facility, provider, insurance order, etc.
  • diagnosis_output (optional): the ICD-10 codes (in claim order) from the diagnosis step.
  • chart_alert_directives (optional): chart-alert / prior-authorization directives.
  • insurance_context (optional): active/inactive and primary/secondary/tertiary insurance details and PA context.
  • nearby_encounter_context (optional): same-patient nearby encounters (same-day, modifier 25, treatment series).
  • coding_rules (optional): organization/user coding rules appended after the baked rule set.

Output

Human-readable text

In the task feed the tool renders a ## CPT Generation charges table (CPT, diagnosis, modifiers, POS, TOS, units, fee, note) and a ## Coding Suggestions table. The full result struct stays in structuredContent.

Note on the prompt source

The CPT system prompt is ported verbatim from Fleming BuildSystemPrompt (up to the rule-insertion point). The CPT user prompt is an assign-authored template with labeled slots (the verbatim body in the workflow doc’s reference section is an ICD-filter prompt and does not match the CPT-generation behavior, so it is not used here).

Notes

  • LLM tool. Billed per call. default_enabled is false.