ANSI X12 837P - 4010 2420F PRV - Referring Provider Specialty Information

The PRV (Provider Information) segment in the 2420F loop of the X12 837 (4010) professional claim is used to convey the referring provider’s specialty or taxonomy code at the service line level. This allows payers to verify the specialty of the provider who referred the patient for the specific service being billed.

The PRV segment is situational. It should be reported when the payer requires the referring provider’s taxonomy information to validate referrals, specialty restrictions, or benefit eligibility. Not all claims or services require this segment.

Sample 837P (4010) – 2420F 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.

Reminder: The referring provider’s taxonomy code must align with payer requirements and NPPES records. For the official taxonomy code set, visit the NUCC Health Care Provider Taxonomy Code Set.

Note: Only include the PRV segment for referring provider specialty information when required by the payer. Omitting it when not required avoids unnecessary rejections.