Q.What are the health care provider taxonomy codes that HIPAA mandates we use when filing some electronic claims? Where can I get a copy of the codes?
A. Under HIPAA, code sets that characterize a general administrative situation, rather than a medical condition or service, are referred to as nonclinical or nonmedical code sets. The National Uniform Claim Committee Health Care Provider Taxonomy code set is an external, nonmedical data code set for classifying physicians and providers according to type or specialty in an electronic environment. Requirements to report the code vary from one health plan to another. One way to help avoid claim denials is to read the provider manual from each insurance you are contracted with to see what (if listed) it requires regarding taxonomy codes.
View the code set, and select the taxonomy code(s) that most closely represents your education, license, or certification. In cases where more than one taxonomy code applies, a health plan may prefer that you use one over another when submitting claims for certain services.
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Last Updated On
April 07, 2021
Originally Published On
March 23, 2010