PRV

Assistant Surgeon Specialty Information

Pos: 255	Max: 1
Detail - Optional
Loop: 2310D	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

AS

Assistant Surgeon

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

M

AN

1/30

Required

ExternalCodeList

Name: HCPT

Description: Health Care Provider Taxonomy

Notes:

1. Information in the Loop ID-2310 applies to the entire claim unless overridden on a service line by the presence of loop ID-2420 with the
same value in the NM101.
2. Required when the Assistant Surgeon specialty information is needed to facilitate reimbursement of the claim.

Example:

PRV*AS*ZZ*1223S0112Y~