Health Information Management Professionals' Interest and Perception of Clinical Coding Practice: A Systematic Review

Abstract

This paper synthesises available peer-reviewed and grey literature on HIM professionals' interest in, and perceptions of clinical coding practice. A structured literature search was conducted using academic search engines and indexed databases, supplemented by targeted grey-literature searches. Findings were narratively synthesised using thematic analysis, and are reported with American Psychological Association (APA, 7th edition) in-text citations and references. Eleven studies and reviews meeting the inclusion focus were identified, spanning Iran, Portugal, Australia, the United Kingdom, Canada, Nigeria, and Malaysia. Four dominant themes emerged: (1) HIM professionals generally perceive clinical coding as important for patient care, funding, and research, but view the coding process itself as burdensome;  documentation quality, terminology ambiguity, and time pressure are the most consistently reported perceived barriers to accurate coding; interest in coding as a specialisation is shaped by training exposure, confidence with technology and classification systems, perceived career progression, and workload/remuneration; and attitudes toward computer-assisted coding and artificial intelligence are cautiously positive, tempered by concerns about deskilling and job security. The study concluded that HIM professionals across diverse settings value clinical coding's importance but experience it as cognitively demanding and under-supported by training, documentation quality, and organisational systems. Strengthening pre-service exposure to coding, structured mentorship, clinician–coder collaboration, and thoughtfully implemented coding technologies could improve both interest in and perception of coding practice.