Workflow Codes

Endpoints alone do not identify an NHCX transaction. A new preauthorisation, a resubmission, an enhancement and a query response all travel on /v1/preauth/submit carrying the same bundle. What separates them is the workflow code in the x-hcx-workflow_id header. Each code also expects a particular status word, given here beside it. The source is the official Workflow Status Sheet on the portal, updated 18 August 2026, which remains the authority as codes are added.

The A-series registry and session calls carry no workflow code because they are infrastructure calls rather than claim transactions.

Workflow Code Prefix Families

NHA organizes workflow codes into numeric mainline cashless codes and alphanumeric families:

Prefix	Family Name	Scope & Operational Coverage
`R`	Reimbursement	Mirrors the numeric cashless codes for the reimbursement route - the patient paid, and is claiming it back.
`G`	Grievance	Raising a grievance, its acknowledgement, and its failure path.
`RP`	Return payment	Money going back the other way.
`N`	Notifications	Push notifications addressed to payer, provider or beneficiary.
`DC`	Discharge correction	Correcting a discharge already submitted.
`PC`	Preauth cancellation	Withdrawing a pre-authorisation. Raised on /v1/task/submit with code `cancel`, not on the preauth endpoint.

Mainline Cashless State Machines

In the diagrams below, each arrow carries the workflow code of the message that moves the case.

Preauthorisation Lifecycle

Claim Lifecycle

Payment & Settlement Lifecycle

Master Catalog of All 74 Workflow Codes

Complete index of all published codes:

Code	Meaning / Name	Sent By	Permitted Statuses	Stages / Outcomes	Reused
`10`	Patient Registered	Provider	`request.initiated`	Patient Registered	No
`11`	Patient Admitted	Provider	`request.initiated`	Patient Admitted	No
`12`	Preauth Request Initiated	Provider	`request.initiated`	Preauth Request Initiated	No
`121`	Preauth Request Resubmitted	Provider	`request.initiated`	PreAuth Reprocess(Resubmission) Initimation	No
`PC01`	Preauth Cancel Initiated	Provider	`request.initiated`	Preauthorization Cancellation	No
`19`	Preauth Query Response Submitted	Provider	`response.complete`	PreAuth Query Response Submitted	No
`13`	Enhancement Request Initiated	Provider	`request.initiated`	Enhancement Request Initiated	No
`131`	Enhancement Query Response Submitted	Provider	`response.partial`, `response.error`, `response.complete`	Enhancement Query Ack Success, Enhancement Query Ack Failed, Enhancement Query Response Submitted	Yes
`14`	Discharge Submitted	Provider	`request.initiated`	Discharge Submitted	No
`141`	Discharge Query Response Submitted	Provider	`response.complete`	Discharge Query Response Submitted	No
`15`	Claim Request Initiated	Provider	`request.initiated`	Claim Request Initiated	No
`151`	Claim Query Response Submitted	Provider	`response.complete`	Claim Query Response Submitted	No
`17`	Payment Received	Provider	`response.complete`	Payment Notice Recived	No
`36`	Claim Arbitration Request Submitted	Provider	`request.initiated`	Claim Arbitration Intimation	No
`20`	Preauth Request Received	Payer	`response.partial`, `response.error`	PreAuth Ack Success, PreAuth Ack Failed	Yes
`21`	Preauth Request Approved	Payer	`response.complete`	Preauth Request Approved	No
`22`	Enhancement Request Approved	Payer	`response.complete`	Enhancement Request Approved	No
`23`	Preauth Request Rejected	Payer	`response.complete`	PreAuth Request Rejected	No
`24`	Preauth Request Queried	Payer	`request.initiated`	PreAuth Request Queried	No
`241`	Enhancement Request Queried	Payer	`request.initiated`	Enhancement Query Raise	No
`25`	Claim Request Received	Payer	`response.partial`, `response.error`	Claim Doc Ack Success, Claim Doc Ack Failed	Yes
`26`	Claim Request Approved	Payer	`response.complete`	Claim Request Approved	No
`27`	Claim Request Queried	Payer	`request.initiated`, `response.partial/complete`	Claim Request Queried, Claim Request Queried	Yes
`28`	Claim Request In Process	Payer	`response.partial`	Claim Request in process	No
`29`	Claim Forwarded	Payer	`response.partial`	Claim Forwarded	No
`251`	Reprocess Request Received	Payer	`response.complete`	PreAuth Reprocess Ack	No
`252`	Reprocess Request Approved	Payer	`response.complete`	Reprocess Request Approved	No
`253`	Reprocess Request Rejected	Payer	`response.complete`	Reprocess Request Rejected	No
`254`	Reprocess Request Queried	Payer	`request.initiated`	Reprocess Request Queried	No
`261`	Discharge Request Approved	Payer	`response.partial`	Discharge Request Approved	No
`262`	Discharge Request Rejected	Payer	`response.complete`	Discharge Request Rejected	No
`263`	Discharge Request Queried	Payer	`request.initiated`	Discharge Request Queried	No
`30`	Payment Initiated	Payer	`request.initiated`, `response.partial`, `response.error`	Payment Notice Initmation, Payment Notice Ack Success, Payment Notice Ack Failed	Yes
`31`	Payment Processed	Payer	`request.initiated`	Payment Processed	No
`33`	Payment Settled	Payer	`request.initiated`	Payment Settled	No
`45`	Final Bill Initimation		`request.initiated`, `response.partial`, `response.error`	Final Bill Initimation, Final Bill Ack Success, Final Bill Ack Failed	Yes
`181`	Final Bill Query Response		`response.complete`	Final Bill Query Response	No
`161`	Claim Doc Query Response		`response.complete`	Claim Doc Query Response	No
`18`	Preauth Query Ack Success		`response.partial`, `response.error`	PreAuth Query Ack Success, PreAuth Query Ack Failed	Yes
`231`	Enhancement Deny		`response.complete`	Enhancement Deny	No
`46`	Final Bill Approve		`response.complete`	Final Bill Approve	No
`47`	Final Bill Query Raise		`request.initiated`, `response.partial`, `response.error`	Final Bill Query Raise, Final Bill Query Ack Success, Final Bill Query Ack Failed	Yes
`491`	Final Bill Deny		`response.complete`	Final Bill Deny	No
`291`	Claim Doc Deny		`response.complete`	Claim Doc Deny	No
`R122`	Reimburstment Claim Reprocess Requested		`request.initiated`	Reimburstment Claim Reprocess Requested	No
`R15`	Reimburstment Claim Submitted		`request.initiated`	Reimburstment Claim Submitted	No
`R151`	Reimburstment Claim Query Response Submitted		`response.complete`	Reimburstment Claim Query Response Submitted	No
`R252`	Reimburstment Claim Reprocess Request Approved		`response.complete`	Reimburstment Claim Reprocess Request Approved	No
`R253`	Reimburstment Claim Reprocess Request Rejected		`response.complete`	Reimburstment Claim Reprocess Request Rejected	No
`R254`	Reimburstment Claim Reprocess Request Queried		`request.initiated`	Reimburstment Claim Reprocess Request Queried	No
`R26`	Reimburstment Claim Approved		`response.complete`	Reimburstment Claim Approved	No
`R27`	Reimburstment Claim Queried		`request.initiated`	Reimburstment Claim Queried	No
`R28`	Reimburstment Claim Evaluation In Process		`response.partial`	Reimburstment Claim evaluation in process	No
`R291`	Reimburstment Claim Rejected		`response.complete`	Reimburstment Claim Rejected	No
`34`	Wallet Upgrade Intimation		`request.initiated`	Wallet Upgrade Intimation	No
`38`	Fraud Alert		`request.initiated`	Fraud Alert	No
`35`	Wallet Upgrade Acknowledgement		`response.complete`	Wallet Upgrade Acknowledgement	No
`37`	Claim Arbitration Acknowledgement		`response.complete`	Claim Arbitration Acknowledgement	No
`39`	Fraud Alert Acknowledgement		`response.complete`	Fraud Alert Acknowledgement	No
`G11`	Grievance Intimation		`request.initiated`	Grievance Intimation	No
`G12`	Grievance Acknowledment		`response.complete`	Grievance Acknowledment	No
`G13`	Grievance Intimation Failure		`response.error`	Grievance Intimation Failure	No
`41`	Preauth Arbitration Intimation		`request.initiated`	Preauth Arbitration Intimation	No
`42`	Preauth Arbitration Acknowledgement		`response.complete`	Preauth Arbitration Acknowledgement	No
`RP1`	Return Payment Intimation		`request.initiated`	Return Payment Intimation	No
`RP2`	Return Payment Acknowledgement		`response.complete`	Return Payment Acknowledgement	No
`RP3`	Return Payment Failure		`response.error`	Return Payment Failure	No
`N01`	Notifications Intended To Payer		`request.initiated`	Notifications Intended to Payer	No
`N02`	Notifications Intended To Provider		`request.initiated`	Notifications Intended to Provider	No
`N03`	Notifications Intended To Beneficiary		`request.initiated`	Notifications Intended to Beneficiary	No
`N04`	Acknowledgement Of The Notificaion		`response.complete`	Acknowledgement of the Notificaion	No
`DC01`	Discharge Correction Intimation		`request.initiated`	Discharge Correction Intimation	No
`DC02`	Acknowledgement For Discharge Correction		`response.complete`	Acknowledgement for Discharge Correction	No
`PC02`	Preauthorization Cancellation Accomplished		`response.complete`	Preauthorization Cancellation Accomplished	No

Reconciled Discrepancies and Authority Rules

Seven codes are published differently in the PMJAY Handbook and the Workflow Status Sheet, resolved here by taking the Workflow Status Sheet as the definitive authority:

Code	PMJAY Handbook	Workflow Status Sheet
`17`	PAYMENT_RECEIVED, provider-side - "Payment received acknowledgment"	"Payment Notice Recived", response.complete
`24`	Payer-side response code, PREAUTH_REQUEST_QUERIED	"PreAuth Request Queried", header request.initiated
`27`	Payer-side response code, CLAIM_REQUEST_QUERIED	"Claim Request Queried", header request.initiated
`30`	Payer-side, PAYMENT_INITIATED	"Payment Notice Initmation", request.initiated
`31 / 33`	Payer-side response codes	header request.initiated
`251`	REPROCESS_REQUEST_RECEIVED	"PreAuth Reprocess Ack"
`36`	CLAIM_ARBITRATION_REQUEST_SUBMITTED, use case "Reprocess/Erroneous request"	"Claim Arbitration Intimation"

The same authority settles these conflicts across official NHA publications (Workflow Status Sheet vs PMJAY Handbook vs Value Sets):

251: Reconciled as Preauthorisation Resubmission acknowledgement in the sheet; the PMJAY handbook uses it in its claim reprocess section.
Cancellation (PC01 vs 122): The sheet and handbook code table prescribe PC01 (request) and PC02 (completion). The handbook prose mentions 122, which clashes with R122 (reimbursement claim reprocess). Integrators should strictly use PC01 and PC02 on /v1/task/submit.
18: Defined as Preauthorisation Query Acknowledgement in the sheet; the handbook repurposes it for claim reprocess.
Reprocess (36 vs 18): Section 11 gives 18 for reprocess, while Section 12 gives 36 (Claim Arbitration). Integrators should use 36 with task code reprocess and reason claimrejected.
Shortfall: Rides on 36 as a Task with code reprocess and reason partialpayment, raised only after payment notice 33 has arrived and been acknowledged with 17.
25 and 291: Named as Claim Document acknowledgement and denial in the sheet, and Claim request received and denied in the value sets. Both refer to the same transition.

Protocol Fault Flags

The source sheet's audit flags mark certain code-and-status pairs as protocol errors rather than normal traffic:

For 131, 45, 47, and 30, sending either response.partial or response.error is flagged as an invalid state transition.
18 sent with response.error is flagged as an invalid terminal state.
Query 27 sent as response.partial or response.complete is invalid (must be request.initiated).

Workflow Code Prefix Families​

Mainline Cashless State Machines​

Preauthorisation Lifecycle​

Claim Lifecycle​

Payment & Settlement Lifecycle​

Master Catalog of All 74 Workflow Codes​

Reconciled Discrepancies and Authority Rules​

Protocol Fault Flags​