Diagnosis Related Groups (DRGs) and the Tenth Revision of the International Statistical Classification of Disease and Related Health Problems (ICD-10) were implemented to Taiwan in 2010 and 2016 respectively. New rules related to the medical costs reimbursement were great challenges facing medical institutions. One of the medical centers in north Taiwan introduced an ICD e-dictionary, DRGs cloud computing system, and integrated them into the hospital information system. Further, developing a medical coder specialization work model optimized the workflow, coding quality, and efficiency, which defeated the adverse effects of DRGs and ICD-10 implementation successfully.