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ClaimGuard

CLI ToolFebruary 9, 2026

Autonomous medical billing denial prediction agent. Analyzes claims against CMS/NCCI rules to flag risks before submission — 100% local, HIPAA-safe by design.

TypeScript
Bun
SQLite
Claude AI
Medical Billing
CLI
TUI
Open Source

Key Features

  • ICD-10 and HCPCS code validation against CMS database
  • NCCI procedure-to-procedure edit conflict detection
  • Medically unlikely edit (MUE) unit limit enforcement
  • Add-on code and modifier validation
  • Age/sex demographic appropriateness checks
  • 0-100 risk scoring with severity breakdown
  • All CMS rules data stored locally in SQLite
  • No PHI leaves your environment, HIPAA-safe