PRV

Billing/Pay-To Provider Specialty Information

Pos: 003	Max: 1
Detail - Optional
Loop: 2000A	Elements: 3

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

BI

Billing

PT

Pay-To

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.

M

ID

2/3

Required

Code

Name

ZZ

Mutually Defined

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

M

AN

1/30

Required

ExternalCodeList

Name: HCPT

Description: Health Care Provider Taxonomy

Notes:

1. Required when adjudication is known to be impacted by the provider taxonomy code, and the Service Facility Provider is the same entity as the Billing and/or Pay-to Provider. In these cases, the Rendering Provider is being identified at this level for all subsequent claims/encounters in this HL and Loop ID-2310E is not used.
2. PRV02 qualifies PRV03.

Example:

PRV*BI*ZZ*203BA0200N~