Pg. 221-222 from the 5010 278 (X217) IG guide states that value code AD in PRV01 should be used only when NM101=AAJ, value code AS when NM101=DD and ect.
What value should be used in PRV01 when the value code in NM01 is equal to 77, FA, G3, QB, or QV?
The PRV is situational segment, required when request is for services of a specialist or specialty entity to indicate the provider's specialty.
Could you please provide the definition of specialist and specialty entity?
The guide does not support PRV01 values when NM101 equals 77, FA, G3, QB, or QV. It is not always necessary to have a one to one relationship between the NM101 values and the PRV01 values. One of the intentions of the PRV segment is to allow a request to a specific specialist/specialty versus identifying an individual provider utilizing the NM108/NM109.
A specialist is one who is devoted to a particular occupation or branch of study, or research. A specialty entity is considered a non-person, but also is devoted to a particular occupation or branch of study, or research.
Your questions have identified some concerns from the workgroup that limits the use of this segment. This situation will be discussed and potentially we may revisit the instructions re the PRV01 values and their direct relationship with the NM101 values.