What are the Healthcare Provider Taxonomy codes? Where may I obtain a copy of the codes?
Answer : The Healthcare Provider Taxonomy codes are a HIPAA standard code set named in the implementation specifications for some of the ASC X12 standard HIPAA transactions. The “Healthcare Provider Taxonomy Code” is a situational data element in the X12 Implementation Guides for the 837 4010A1 Institutional and Professional claims/encounter information transactions. If the Taxonomy code is required in order to properly pay or process a claim/encounter information transaction, it is required to be reported. Thus, reporting of the Healthcare Provider Taxonomy Code varies from one health plan to another. The Healthcare Provider Taxonomy code set divides health care providers into hierarchical groupings by type, classification, and specialization, and assigns a code to each grouping. The Taxonomy consists of two parts: individuals (e.g., physicians) and non-individuals (e.g., ambulatory health care facilities). All codes are alphanumeric and are 10 positions in length. These codes are not “assigned” to health care providers; rather, health care providers select the taxonomy code(s) that most closely represents their education, license, or certification. If a health care provider has more than one taxonomy code associated with it, a health plan may prefer that the health care provider use one over another when submitting claims for certain services. The Healthcare Provider Taxonomy code set is available at no charge from the Washington Publishing Company’s website: http://www.wpc-edi.com/codes/taxonomy The Healthcare Provider Taxonomy code set is maintained by the National Uniform Claim Committee (NUCC). The NUCC accepts requests for new codes and requests for changes to existing codes or descriptions. The criteria for review of a request for a new code or a change are available on the NUCC web site at: www.nucc.org The code set is updated twice a year.
Answer : The Healthcare Provider Taxonomy codes are a HIPAA standard code set named in the implementation specifications for some of the ASC X12 standard HIPAA transactions. The “Healthcare Provider Taxonomy Code” is a situational data element in the X12 Implementation Guides for the 837 4010A1 Institutional and Professional claims/encounter information transactions. If the Taxonomy code is required in order to properly pay or process a claim/encounter information transaction, it is required to be reported. Thus, reporting of the Healthcare Provider Taxonomy Code varies from one health plan to another. The Healthcare Provider Taxonomy code set divides health care providers into hierarchical groupings by type, classification, and specialization, and assigns a code to each grouping. The Taxonomy consists of two parts: individuals (e.g., physicians) and non-individuals (e.g., ambulatory health care facilities). All codes are alphanumeric and are 10 positions in length. These codes are not “assigned” to health care providers; rather, health care providers select the taxonomy code(s) that most closely represents their education, license, or certification. If a health care provider has more than one taxonomy code associated with it, a health plan may prefer that the health care provider use one over another when submitting claims for certain services. The Healthcare Provider Taxonomy code set is available at no charge from the Washington Publishing Company’s website: http://www.wpc-edi.com/codes/taxonomy The Healthcare Provider Taxonomy code set is maintained by the National Uniform Claim Committee (NUCC). The NUCC accepts requests for new codes and requests for changes to existing codes or descriptions. The criteria for review of a request for a new code or a change are available on the NUCC web site at: www.nucc.org The code set is updated twice a year.
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