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This document covers the deterministic skip-decision rules used by the realtime coding workflow. These rules are now implemented by the coding_skip_check backend tool (see coding-skip-check.md); this page describes the rules it applies. Call the tool after each relevant EHR fetch step.

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Agent Skip-Check Instructions

Run deterministic checks before the workflow spends API and LLM budget. Apply them twice:
  1. After summary fetch, to reject encounters that are not ready or already coded.
  2. After patient-level signal fetch, to reject alert-driven self-pay/cash-pay/Buy-Bill/provider cases.

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Inputs To Inspect

Required:
  • ehr_type: athenaHealth, DrChrono, or amd.
Optional:
  • summary
  • documentation
  • chart_alert
  • doctor_flags
  • allowed_appointment_types
  • blocked_department_ids
  • force_recode

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Checks

The agent should check for:
  • existing procedure codes when force_recode=false,
  • blocked department signals,
  • DrChrono clinical note not locked,
  • Athena multi-appointment same-day signals,
  • chart-alert self-pay/cash-pay signals,
  • DrChrono cash-pay flags.

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Output Shape

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Agent Instruction Guidance

If skip=true, stop the workflow and show the reason in the task feed. Do not fetch documentation or call LLM tools.