Trouble Taxonomy Codes for Professional/ANSI

Trouble Taxonomy Codes for Professional/ANSI

Index

  • Sections
    • Rendering Taxonomy
    • Billing Taxonomy

Question: If I have rejected claims that are missing a taxonomy code, where do I go to fix it? What do I do next?

Answer:  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. (source)

WHERE TO LOOK FIRST:

Which Taxonomy code are you adding, Rendering or Billing?

Taxonomy codes don’t come from ICANotes, and unfortunately we cannot provide this information to you.

Taxonomy codes are entered in the Provider Payer Rules tab in Individual Settings and Directories

Rendering Taxonomy

1. The Rendering Taxonomy code is set in Settings & Directories > Billing Rates & Payer Rules > Provider Payer Rules.

2. You can set the Rendering Taxonomy so that it populates for all payers, or for a specific payer by selecting the appropriate payer name in the Insurance Payer box on the left.


3. No additional settings need to be set for this taxonomy. However, if the Rendering Provider Loop is not populating in the ANSI you will need to enable the following ANSI rule for the insurance payer(s):


4. Always Send Rendering Provider Loop.


5. Prep the claim to see the new change.

6. On the CMS 1500 (HCFA) the Rendering Taxonomy will populate in 24J shaded and in the Rendering Provider Loop 2310B.

Billing Taxonomy


1. The Billing Taxonomy code is set in Settings & Directories > Billing Rates & Payer Rules > Provider Payer Rules.

2. Additional settings need to be enabled in order for the Billing Taxonomy to appear on the claim. Go to
Group Level Settings & Directories > Insur Payer.

3. And select the insurance payer to send the Billing Taxonomy code to. You may need to do this for just one payer, multiple payers, or all. Set the ANSI options as follows:

  • Send Taxonomy Code in Service Facility Loop
  • Always Send Service Facility Loop
  • Use Taxonomy Code in 33b on CMS 1500



BE SURE TO SAVE AFTER SELECTING THESE RULES FOR THAT PAYER!

4. After prepping the claim you will now see the Billing Taxonomy in the CMS 1500 (HCFA)

5. And the ANSI

6. You can have both the Rendering and Billing Taxonomies populated on your claim. Enter the codes as outlined above for the Rendering and Billing taxonomies.

7. After you've corrected your Provider Payer Rules, to re-bill them to your clearinghouse and payer you will go to the Billing/Productivity Report and use available filters to search for your already submitted claims.

Tip: Use Ebilling/Insurance Options button to specify claims that are Prepared/Saved to File, as this represents the last step of claim submission within ICANotes. Rebilling is essentially the same process as billing in that you will (re)prep and submit the claim.

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