Placing a Taxonomy code on a claim will vary depending on the method, paper or electronic, and if electronic, may still vary further depending on what clearinghouse you’re sending to, and what electronic method is used to generate the claims.
First let’s take a look at “Paper claims”, and “Print-image for electronic claims”. With these methods, you’ll likely be placing the “Rending/Individual” Taxonomy in Box 24j (Shaded), and/or the “Practice/Group” Taxonomy in 33b. The requirements can vary from payer to payer, so please check with your payer for details.
To populate Box 24j (Shaded), you will need to utilize the “Provider IDs” tab for each Provider you’ll be billing claims for. Go to Lists, then Provider, then Providers. Select a provider, click Edit, then go to the Provider IDs tab.
If you need to send a Taxonomy Code in Box 24j (Shaded) for ALL insurances, edit the “All/All/All” line. If you need to send it just for a certain insurance, select and Edit that line. If you do not see an “All/All/All” line, or one for the specific insurance you need to send it to, you can click New to make an entry.
Select Legacy Identifier 1, and enter the Rendering/Individual Taxonomy Code. Click in the field to the right to enter the qualifier “ZZ” (without quotation marks), this will populate Box 24i (Shaded). Click OK, then Save, when finished.
To populate Box 33b, you will need to utilize the “Practice IDs” tab. Go to File, then Practice Information. Go to the Practice IDs tab.
*Note: If you’re Provider IDs grid entries are “Individual” then those values will populate Box 33b as well, and you do not need to follow this section of the guide.
If you need to send a Taxonomy Code in Box 33b for ALL insurances, edit the “All/All/All” line. If you need to send it just for a certain insurance, select and Edit that line. If you do not see an “All/All/All” line, or one for the specific insurance you need to send it you, you click New to make an entry.
To populate 33b, select Legacy Identifier 1, and enter the Practice/Group Taxonomy Code. Click in the field to the right to enter the qualifier “ZZ” (without quotation marks), this will populate Box 33b. Click OK, then OK, when finished.
Placing Taxonomy codes in Electronic claims, such as those sent using “Revenue Management” is slightly different, and there is one option that may need to be checked on Insurances.
To populate Loop 2310B (Segment PRV), you will need to utilize the “Provider IDs” tab for each Provider you’ll be billing claims for. Go to Lists, then Provider, then Providers. Select a provider, then go to the Provider IDs tab.
Edit the “All/All/All” line, a specific Insurance line, or add a new line as needed… the difference being; Use the “Taxonomy” field instead of the “Legacy Identifier 1” field. Note; If set to “Individual”, this will override practice settings. To use practice IDs entries (in addition to Provider IDs), use the “Group” option.
Similarly, to populate Loop 2000A (Segment PRV), you will need to utilize the “Practice IDs” tab. Go to File, then Practice Information. Select the Practice IDs tab.
Edit the “All/All/All” line, a specific Insurance line, or add a new line as needed… the difference being; Use the “Taxonomy” field instead of the “Legacy Identifier 1” field.
For any Insurances that need the “Practice/Group” Taxonomy in Loop 2000A you will also need to select the “Send Practice Taxonomy…” option in the Insurance entry, on the “EDI/Eligibility” tab.
