PRV Taxonomy Codes Segment

PRV Taxonomy Codes Segment Description

The PRV Taxonomy Codes segment is used to the provider type by a 10-digit identification number known as a Taxonomy-Specialty code.  These codes are used by the health plan’s claim adjudication logic. The X12 standard says this segment is required only if the payer’s adjudication is known to be impacted by the provider taxonomy code. Experience shows most providers send this segment even though it is not absolutely mandatory in the TR3. To learn more  about EDI TR3s visit our course schedule page to sign up for a class.

Transactions Used In

The PRV segment mainly used in the 837 but it is also used in the HIPAA EDI Transactions:

  • 270/271 Eligibility, Coverage or Benefit Inquiry Response 005010X279A1 007030X332
  • 275 Health Care Attachment 005010X210 007030X341
  • 278 Health Care Services Review Information 005010X217 007030X342
  • 834 Benefit Enrollment and Maintenance 005010X220A1 007030X333 007030X346
  • 837 Professional 005010X222A1 007030X323
  • 837 Professional 005010X223A2 007030X324
  • 837 Professional 005010X224A2 007030X325

The PRV is found in the following 837 Loops

The billing provider taxonomy code will be found in 2000A 837-D, 837-P, 837-I … PRV*BI Billing for all 837 transaction sets. Taxonomy codes should be sent at the downstream loops only if they are different from the billing provider loop 2000A.

2000A PRV*BI*PXC*1223G0001X – Billing General Practice Dental Providers
2310A PRV*RF*PXC*1223G0001X – Referring General Practice Dental Providers Claim Level
2310B PRV*PE*PXC*1223E0200X – Performing Endodontics Claim Level Rendering Provider

2310D PRV*AS*PXC*1223S0112X – AS Assistant Surgeon Oral Surgery Claim Level
2420A PRV*PE*PXC*1223E0200X – Performing Endodontics Line Level Rendering Provider
2420B PRV*AS*PXC*1223S0112X – AS Assistant Surgeon Oral Surgery  Line Level

2000A PRV*BI*PXC*207Q00000X – Billing Family Medicine

2310B PRV*PE*PXC*207QS1201X – Performing Sleep Medicine Claim Level Rendering Provider

2420A PRV*PE*PXC*207QG0300X – Performing Geriatric Medicine Line Level Rendering Provider

2000A PRV*BI*PXC*282NR1301X– Billing General Acute Care Hospital

2310A PRV*AT*PXC*207PE0004X – Attending Emergency Medical Service Claim Level Rendering Provider

PRV Taxonomy Codes Segment Examples

PRV*BI*PXC*122300000X – BI Billing Provider Taxonomy Code for a Dentist
PRV*AT*PXC*207P00000X – AT Attending Provider Taxonomy Code for Emergency Medicine
PRV*PE*PXC*204C00000X – PE Performing Taxonomy Code Neuromusculoskeletal Medicine, Sports Medicine

PRV*RF*PXC*207N00000X – RF Referring Taxonomy Code Dermatology Allopathic & Osteopathic Physicians

PRV*AS*PXC*1223S0112X – AS Assistant Surgeon Taxonomy Code Oral Surgery (Dentist only).

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