- Outpatient Institutional Providers Reimbursed Under MPFS: When to Split Claims for Updated Rates
- Outpatient Services for Registered Inpatients
- Allergen Immunotherapy Preparation (95144-95165)
- Ambulatory Surgical Center Approved HCPCS Codes and Payment Rates
- Billing for FQHC MAO Plan Supplemental Payment (PPS Providers)
- Billing for Services Not Included in the FQHC Benefit
- Attention all OPPS Providers: Provider-Based Department Edits Being Implemented on/after 8/1/2023
- Billing for Drug Wastage: JW and JZ Modifier
- Billing Medicare for a Denial - Condition Code 21
- URGENT: Billing Reminders for OPPS Providers with Multiple Service Locations
- Billing Medicare Part A When Veteran’s Administration Eligible Medicare Beneficiaries Receive Services in Non-VA Facilities
- Condition Code G0 Reminder
- CPT Code 15830: Excision, Excess Skin and Subcutaneous Tissue; Abdomen, Infraumbilical Panniculectomy
- Medicare Part B Electronic Claims that Exceed the Threshold for Charges and Units of Service
- ESRD Facilities: Clarification for Providing Dialysis Services to Patients Acute Kidney Injury
- Federally Qualified Health Centers Behavioral Health Claims Job Aid
- Federally Qualified Health Centers Contracting with Medicare Advantage Plans
- Fee-For-Time Compensation Arrangement and Reciprocal Billing Job Aid
- Answers to Common Fee-for-Time Compensation Arrangements Questions
- FQHC and Group Therapy Services Job Aid
- Long-Term Care Hospitals: How to Request Adjustments of Claims Paid at the Site Neutral Rate
- Inhalation Treatment CPT 94640 – Billing Errors
- Immunization Roster Billing
- Nonphysician Practitioners Billing for Surgical Procedures
- Professional Services During a Patient Hospice Election
- Professional Services During a Patient Hospice Election
- Proper Billing for Finger and Toe Procedures
- Proper Submission of Fee-For-Time Compensation Arrangements and Reciprocal Billing Arrangements
- Proper Use of Taxonomy Codes
- A/B Rebilling Facts
- Common Reciprocal Billing Questions and Answers
- Reminder for Avoiding Claim Denials for Positron Emission Tomography Scans
- Reminder on Deleting Revenue Code Line(s) in the Fiscal Intermediary Standard System Direct Data Entry System
- Repetitive Outpatient Services for Providers Submitting Institutional Outpatient Claims
- Reporting Multiple Qualifying Visits on the Same Date of Service for FQHC Reimbursement
- Unlisted and Not Otherwise Classified Procedure Codes
- What All Facilities Need to Know About the Long-Term Care Hospital Three-Day or Less Interrupted Stay Policy
- Fiscal Year/Calendar Year Claim Split
Proper Use of Taxonomy Codes
A taxonomy code is a unique ten-character code that designates your classification and specialization and enables providers to identify their specialty at the claim level.
CMS developed a crosswalk of taxonomy codes that links the types of providers and suppliers who are eligible to apply for enrollment in the Medicare program with the appropriate Healthcare Provider Taxonomy Codes.
Note: The code set is updated and published twice a year, in January and July.
Although, the taxonomy code is not required it is strongly recommended as it assists immensely in the processing of claims by identifying which PTAN to select in order to adjudicate a claim.
Note: The NPI is intended as an identification number to share with other suppliers and providers, health plans, clearinghouses and any entity that may need it for billing purposes. A PTAN, on the other hand, is specific to Medicare and is issued to providers upon enrollment with the MAC.
The use of a taxonomy code is recommended if there is more than one PTAN with different specialties associated to one NPI. The taxonomy code helps to make the one-to-one match with the correct PTAN. Also, it is imperative that when the taxonomy code is reported on a claim it is valid for the specialty billing the services and placed in the correct field on the claim. The placement of the taxonomy code is dependent on if it is being reported for the billing provider or rendering provider; and should be reported as the following:
- Rendering –Loop 2310B PRV03 or Loop 2420A field PRV03; qualifier PE, segment PRV01
- Billing – Loop 2000A PRV03; qualifier BI, segment PRV01
When a taxonomy code is improperly used or not reported it can cause the following issues during claim processing:
- Delay in processing/payment
- Claim denials
- Improper payments
Reviewed 8/28/2024