> ## Documentation Index
> Fetch the complete documentation index at: https://docs.rcintell.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Get PA documentation requirements

> Get documentation requirements for a specific code at a payer.



## OpenAPI

````yaml /docs/openapi.client.json get /v1/prior-auth/documentation/{payer_slug}/{code}
openapi: 3.1.0
info:
  description: >-
    Client API for RCIntel. Admin ingest, catalog sync, and internal audit
    routes are omitted. See Guides → Which API to use.
  summary: Multi-tenant knowledge API for healthcare revenue cycle management.
  title: Healthcare Knowledge Layer
  version: 0.1.0
servers: []
security: []
tags:
  - description: >-
      Geographic payer policy lookup (national NCD vs MAC LCD vs state). Query
      payer, code, state, plan_type. Each row includes geo_scope and
      document_version.
    name: policies
  - description: >-
      Payer network directory — search payers, check prior auth requirements,
      view filing rules, denial patterns, and appeal levels.
    name: payers
  - description: >-
      Resolve healthcare billing knowledge across the L1-L6 layer stack.
      Includes payment calculation, billing guidance, and per-layer queries.
    name: knowledge
  - description: >-
      CMS Fee Schedule lookups — OPPS (Addendum B / APC), DMEPOS (state-level
      pricing), and Clinical Lab Fee Schedule (CLFS).
    name: fee-schedules
  - description: >-
      NCCI (National Correct Coding Initiative) — dedicated MUE limits, PTP
      bundling edits, add-on code edits, and code pair validation.
    name: ncci
  - description: >-
      Service code intelligence — CPT/HCPCS lookup, RVU data, NCCI edits,
      payment calculation, implant/GUDID search, and service group
      classification.
    name: codes
  - description: >-
      Submit asynchronous AI agent jobs for code research, medical necessity,
      and denial resolution. Poll for results and retrieve reasoning traces.
    name: agents
  - description: >-
      Register and manage healthcare facilities by CCN (Medicare Provider
      Number). Each facility is the root entity for knowledge resolution.
    name: facilities
  - description: >-
      NPI Registry — live search against CMS NPPES API for provider and
      organization National Provider Identifiers.
    name: npi
  - description: >-
      OpenFDA drug product lookup by NDC. Includes product-level fields with
      normalized ingredient and package detail.
    name: drugs
  - description: Health checks, service metadata, and Prometheus metrics.
    name: system
paths:
  /v1/prior-auth/documentation/{payer_slug}/{code}:
    get:
      tags:
        - prior-auth
      summary: Get PA documentation requirements
      description: Get documentation requirements for a specific code at a payer.
      operationId: get_documentation_v1_prior_auth_documentation__payer_slug___code__get
      parameters:
        - description: Normalized payer slug used by the prior-auth knowledge graph.
          in: path
          name: payer_slug
          required: true
          schema:
            title: Payer Slug
            type: string
        - description: >-
            Billing or terminology code value (CPT/HCPCS/NDC/etc depending on
            endpoint context).
          in: path
          name: code
          required: true
          schema:
            title: Code
            type: string
      responses:
        '200':
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PADocumentationResponse'
          description: Successful Response
        '422':
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
          description: Validation Error
      security:
        - APIKeyHeader: []
components:
  schemas:
    PADocumentationResponse:
      description: Documentation requirements for a specific code at a payer.
      properties:
        clinical_criteria:
          $ref: '#/components/schemas/ClinicalCriteria'
        code:
          title: Code
          type: string
        documentation_requirements:
          items:
            type: string
          title: Documentation Requirements
          type: array
        medical_necessity_criteria:
          $ref: '#/components/schemas/ClinicalCriteria'
        payer_slug:
          title: Payer Slug
          type: string
        source_document:
          anyOf:
            - type: string
            - type: 'null'
          title: Source Document
        source_url:
          anyOf:
            - type: string
            - type: 'null'
          title: Source Url
      required:
        - payer_slug
        - code
      title: PADocumentationResponse
      type: object
    HTTPValidationError:
      properties:
        detail:
          items:
            $ref: '#/components/schemas/ValidationError'
          title: Detail
          type: array
      title: HTTPValidationError
      type: object
    ClinicalCriteria:
      description: Clinical criteria for PA evaluation.
      properties:
        clinical_notes_required:
          default: false
          title: Clinical Notes Required
          type: boolean
        diagnosis_required:
          default: false
          title: Diagnosis Required
          type: boolean
        icd10_examples:
          items:
            type: string
          title: Icd10 Examples
          type: array
        notes:
          anyOf:
            - type: string
            - type: 'null'
          title: Notes
      title: ClinicalCriteria
      type: object
    ValidationError:
      properties:
        ctx:
          title: Context
          type: object
        input:
          title: Input
        loc:
          items:
            anyOf:
              - type: string
              - type: integer
          title: Location
          type: array
        msg:
          title: Message
          type: string
        type:
          title: Error Type
          type: string
      required:
        - loc
        - msg
        - type
      title: ValidationError
      type: object
  securitySchemes:
    APIKeyHeader:
      in: header
      name: X-API-Key
      type: apiKey

````