Preauthorizations

Preauths Process Guide: Remove Preauth Diagnosis Workflow

Preauths Process Guide: Remove Preauth Diagnosis

1. Overview

This guide covers removing a diagnosis from an existing pre-authorization (DELETE /preauths/diagnoses/{icd_code}). Diagnoses are attached when the preauth is created (via POST /preauths); this endpoint lets a facility take one diagnosis back off a preauth that is still being assembled, without cancelling the whole request.

1.1. What This Workflow Does

Detaches a single ICD diagnosis code from a preauth. The diagnosis is identified by the icd_code in the path, and the target preauth is scoped by the consent_token and intervention_code in the body. One diagnosis is removed per call.

1.2. Why This Workflow Is Critical

Correcting Mistakes: Lets a facility fix a diagnosis added in error before the preauth is submitted, without cancelling and rebuilding it.
Data Integrity: Keeps the preauth's diagnoses an accurate reflection of the intended request.
Auditability: Provides a clear, per-item trail of removals.

2. Workflow Details

2.1. Workflow Description

Input Reception: The system receives the icd_code to remove in the path, and the consent_token and intervention_code in the body.
Preauth Identification: The system locates the preauth using the consent_token and intervention_code.
Diagnosis Removal: The matching ICD diagnosis is detached from the preauth.
Outcome Delivery: A confirmation is returned.

2.2. Workflow Data Dictionary

Field Name	Description	Data Type	Required	Purpose
`icd_code`	ICD diagnosis code to remove (path parameter, e.g. `A09`).	String	Yes	Identifies the diagnosis to detach.
`consent_token`	Token authorising the action on the beneficiary's preauth.	String	Yes	Identifies the active preauth context.
`intervention_code`	SHA intervention code the diagnosis is associated with.	String	Yes	Scopes the removal to one intervention.

2.3. Expected Outcomes

Outcome	Description
Success: Diagnosis Removed	The diagnosis was detached from the preauth.
Failure: Invalid Request	A required field was missing or malformed.
Failure: Unauthorized	The authentication token was missing or invalid.
Failure: Forbidden	Tenant/facility context is required and was not satisfied.

3. Critical Success Factors for Integration

Scope Precisely: The consent_token and intervention_code must match the preauth the diagnosis was added to.
Identify the Right Diagnosis: Use the exact ICD icd_code as recorded on the preauth.
Cancel vs Remove: To withdraw an entire preauth, use Cancel Preauth instead of removing every item.

Preauths Process Guide: Remove Preauth Diagnosis Workflow