Luz Posted Fri 28th of July, 2017 14:51:13 PM
We are from a Neurology group, and Iam seeking counsel on how to use a Taxonomy code that does not map into the physician primary specialty. For example, a physician primary specialty is Neurology (13), but he/she is certified in another specialty or subspecialty that may qualify for another specialty such as Neuropsychiatry specialty (86). How do we map this? Your input is appreciated.
SuperCoder Answered Mon 31st of July, 2017 08:16:51 AM
Taxonomy codes are administrative codes set for identifying the provider type and area of specialization for health care providers. Each taxonomy code is a unique ten character alphanumeric code that enables providers to identify their specialty at the claim level.
- Taxonomy codes on electronic claim submissions with the ASC X12N 837P and 837I format are placed in segment PRV03 and loop 2000A for the billing level and segment PRV03 and loop 2420A for the rendering level. For paper UB04 institutional claims, the taxonomy code should be placed in box 81 and should be submitted with the “B3”qualifier.
- For paper CMS-1500 professional claims, the taxonomy code should be identified with the qualifier “ZZ” in the shaded portion of box 24i. The taxonomy code should be placed in the shaded portion of box 24j for the rendering level and in box 33b preceded with the “ZZ” qualifier for the billing level.
If a health care provider might need to report more than one Healthcare Provider Taxonomy Code or code description in order to adequately describe the type/classification/specialization. Therefore, a health care provider may select more than one Healthcare Provider Taxonomy Code or code description when applying for an NPI, but must indicate one of them as the primary
For more information follow undermentioned link.
Hope this helps!