ANSI X12 837P - 4010 2310A PRV - Referring Provider Specialty Information

The PRV (Provider Information) segment in the 2310A loop of the X12 837 (4010) professional claim is used to convey the referring provider’s specialty or taxonomy code. This allows the payer to understand the referring provider’s qualifications, which may impact coverage, referral requirements, or claim adjudication.

The PRV segment is situational. It should only be included when the payer requires the referring provider’s taxonomy code to be explicitly sent. Some payers use this information to validate referral rules, ensure proper specialty routing, or confirm benefit eligibility.

Sample 837P (4010) – 2310A PRV Segment

In the example PRV*RF*ZZ*111N00000X~:

• RF – Provider Code indicating the Referring Provider.
• ZZ – Reference Identification Qualifier, meaning the following value is a Health Care Provider Taxonomy Code.
• 111N00000X – The taxonomy code for a Chiropractor Physician.

Reminder: Ensure that the referring provider’s taxonomy code matches what is on file with the payer and NPPES. For a complete list of taxonomy codes, visit the NUCC Health Care Provider Taxonomy Code Set.

Note: The PRV segment should only be included when the payer requires the referring provider’s taxonomy information. Misalignment with payer records may result in claim rejections.