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

M

ID

2/3

Required

Code

Name

ZZ

Mutually Defined

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 ANSI ASC X12N TG2 WG15.

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
NSF Reference: BA0-22.0

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 Rendering 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-2310B is not used.
2. If the Billing or Pay-to Provider is also the Rendering Provider, and Loop 2310B is not used, this PRV segment is required.
3. This PRV is not used when the Billing or Pay-to Provider is a group and the individual Rendering Provider is in Loop ID-2310B. The PRV segment is then coded with the Rendering Provider in Loop ID-2310B.
4. PRV02 qualifies PRV03.

Example:

PRV*PT*ZZ*1223S0112Y~