This article retrospectively analyzed the present situation and causes of the lack of coding in pathological diagnosis. It found the main reasons for the high missing rate of pathological diagnosis coding includes the late return of pathological results, which is in contradiction with the filing rate of medical records, the weak consciousness of “looking back” and the information barrier between doctors and coders. These also lead to non-enrollment in DRG or low case mix index (CMI) after enrollment. By means of issuing positive pathology reports on multi-platform, opening multi-role authority, coders adding pathological diagnosis codes, and carrying out multi-department and multi-level quality control measures, the integrity, accuracy, standardization, timeliness and authenticity of the data on the front pages of medical records have been improved, and the vocational interaction between the relevant departments has been strengthened, which lays foundation for delicacy management. It suggests that hospital should optimize and upgrade the electronic medical record system, integrate the medical record data, develop the intelligent coding, reduce workload for both clinicians and coders, and carry out special subject quality control measures, so as to make continuous improvement for coding quality of medical records.