PRV

Requester Provider Information

Pos: 240

Max: 1

Detail - Optional

Loop: 2010B

Elements: 3

User Option (Usage): Situational

To specify the identifying characteristics of a provider

Element Summary:

	Ref	Id	Element Name	Req	Type	Min/Max	Usage
	PRV01	1221	Provider Code Description: Code identifying the type of provider	M	ID	1/3	Required

	Code	Name
	AD	Admitting
	AS	Assistant Surgeon
	AT	Attending
	CO	Consulting
	CV	Covering
	OP	Operating
	OR	Ordering
	OT	Other Physician
	PC	Primary Care Physician
	PE	Performing
	RF	Referring

PRV02

128

Reference Identification Qualifier
Description: Code qualifying the Reference Identification
ZZ is used to indicate the “Health Care Provider Taxonomy” code list (provider specialty code) which is available on the Washington Publishing Company web site: http://www.wpc-edi.com. This taxonomy is maintained by the Blue Cross Blue Shield Association and ASC X12N TG2 WG15.

2/3

Required

Code

Name

Mutually Defined

Health Care Provider Taxonomy Code List

PRV03

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Provider Taxonomy Code
Alias: Provider Specialty Code

1/30

Required

	ExternalCodeList
	Name: HCPT
	Description: Health Care Provider Taxonomy

Notes:

1. Required if used by the UMO to identify the requester.
2. PRV02 qualifies PRV03.

Example:

PRV*PC*ZZ*203BA0000Y~

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