Report the Secondary or NPI of the Provider / Clinician / Facility / External External Code Organization defined in this record. Required National National Provider Code Source 3 - NPPES entity type code of the NPI when PV 40 Provider ID 2/2016 int[10] Identification (NPI) 1% B Source 3 National Provider must agree with the type of provider = 0, 1, 2, 3, 2 of the Provider - Integer ID coded in PV034. (i.e. If PV034 = 1 4, or 5 then the NPPES entity code for the NPI in PV040 must be 1.) Required when GIC Report the GIC Assigned Provider GIC Provider Link ID Submitter PV 41 Provider 11/8/12 Text ID GIC Link ID. If not applicable, do not 0% B for GIC Carriers only is identified Link ID report any value here. as a GIC Submitter Report the submitter's proprietary Required specialty code for the provider here. when Carrier Proprietary additional specialty code for a PV034 = 0, Defined Carrier Defined PV 42 Specialty Specialty Code provider should be populated in 1, 2, 3, 4, 90% A0 Table - - Specialty Code elements PV043 and PV044. Value or 5 and Text comes from a Carrier Defined Table PV030 is only. blank Carrier See mapping for primary Defined External Code specialty code in PV030. Known Required Table - Source 4 – Other additional specialty code for a when OR - Specialties PV 43 Specialty 11/8/12 Specialty Code provider should be populated in this PV034 = 0, 0% B External - OR – Code 2 element. Value can come from 1, 2, 3, 4, Code Carrier Defined either a Carrier Defined Table or the or 5 Source 4 Table External Code Source. - Integer Carrier See mapping notes for primary Defined External Code specialty code in PV030. Known Required Source 4 - - Other additional specialty code for a when OR - Specialties PV 44 Specialty 11/8/12 Specialty Code provider should be populated in this PV034 = 0, 0% B External - OR – Code 3 element. Value can come from 1, 2, 3, 4, Code Carrier Defined either a Carrier Defined Table or the or 5 Source 4 Table External Code Source. - Integer
PV 40 National Provider ID 2 2/2016 External Code Source 3 - Integer External Code Source 3 - National Provider ID int[10] National Provider Identification (NPI) of the Provider Report the Secondary or NPI of the Provider / Clinician / Facility / Organization defined in this record. NPPES entity type code of the NPI must agree with the type of provider coded in PV034. (i.e. If PV034 = 1 then the NPPES entity code for the NPI in PV040 must be 1.) Required when = 0, 1, 2, 3, 4, or 5 1% B PV 41 GIC Provider Link ID 11/8/12 Text ID GIC GIC Provider Link ID for GIC Carriers only Report the GIC Assigned Provider Link ID. If not applicable, do not report any value here. Required when Submitter is identified as a GIC Submitter 0% B PV 42 Proprietary Specialty Code Carrier Defined Table - Text Carrier Defined - Specialty Specialty Code Report the submitter's proprietary specialty code for the provider here. additional specialty code for a provider should be populated in elements PV043 and PV044. Value comes from a Carrier Defined Table only. Required when PV034 = 0, 1, 2, 3, 4, or 5 and PV030 is blank 90% A0 PV 43 Other Specialty Code 2 11/8/12 Carrier Defined Table - OR - External Code Source 4 - Integer External Code Source 4 – Specialties - OR – Carrier Defined Table Specialty Code See mapping for primary specialty code in PV030. Known additional specialty code for a provider should be populated in this element. Value can come from either a Carrier Defined Table or the External Code Source. Required when PV034 = 0, 1, 2, 3, 4, or 5 0% B PV 44 Other Specialty Code 3 11/8/12 Carrier Defined - OR - External Code Source 4 - Integer External Code Source 4 - Specialties - OR – Carrier Defined Table Specialty Code See mapping notes for primary specialty code in PV030. Known additional specialty code for a provider should be populated in this element. Value can come from either a Carrier Defined Table or the External Code Source. Required when PV034 = 0, 1, 2, 3, 4, or 5 0% B
v6-apcd-provider-file-submission-guide-FINAL.docx