In the 2100C loop PRV for the PRV 02 HPI is an allowed qualifier for the 270 with the NPI in the PRV03. In the 271 2100C loop PRV02 PXC is the only allowed qualifier and the PRV03 Taxonomy code. When a 271 is returned when the 270 has the HPI qualifier can the element be updated with the qualifier PXC to be in the PRV02 and the Taxonomy code in the PRV03 even if PXC was not sent in the 270 segments.
270 PRV*PE*HPI*112345614789~
271 PRV*PE*PXC*0012255998~
In the 271 response the 2100C/PRV02 does not provide the option to return the HPI qualifier, and the only qualifier available at 2100C PRV02 is PXC. The 271 does not need to have a PXC with a taxonomy code, this is up to the Information Source to determine if they want or need to send to the Information Receiver.
If the NPI in the 270 2100C PRV02 was used to determine the benefits, the 271 2120C NM1 should be used to return the NPI with NM108 = XX and the NPI carried in NM109.
Future versions of the 270/271 TR3 have corrected the expectation to return the NPI in PRV02 when it is used to determine the benefits.
Related RFIs: 1025