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Medical Coding News Archives

Semi-annual Health Care Provider Taxonomy Updates Effective October 1

 
October 29, 2010:
The National Uniform Claim Committee’s semi-annual update to health care provider taxonomy codes were effective October 1, 2010. The update includes new codes, revisions to existing codes, and the addition of definitions to current codes.

The Healthcare Provider Taxonomy Code Set may be used in certain standard transactions to indicate health care provider type, classification, and/or specialization. Healthcare providers are required to choose a taxonomy code from this set when applying for a national provider identifier (NPI). All health care providers, including medical students, interns, residents, and fellows, are eligible to apply for NPIs.

Health care taxonomy codes are an external, nonmedical data code set that was specifically designed for use in the ASC X12N health care transactions, including those mandated under HIPAA. These are unique 10-character alphanumeric codes structured into three distinct levels:

Level I Provider type Example: Allopathic & osteopathic physicians Level II Classification Example: Obstetrics & gynecology Level III Area of specialization Example: Gynecologic oncology

There are categories for individuals, including but not limited to physicians, dental providers, and nursing service-related providers; groups of individuals, multispecialty and single specialty; as well as nonindividuals, such as hospitals, laboratories, suppliers, and transportation services.

Currently, NUCC maintains the code set, and ongoing responsibilities include processing taxonomy code requests and maintaining the codes.

The following three new codes were added on July 1, 2010, with an effective date of October 1, 2010:

TYPE: Nonindividual, other service providers type

CODE: 174200000X Meals classification

Definition: A public or privately owned facility providing meals to individuals traveling long distances or receiving prolonged outpatient medical services away from home.

TYPE: Individual, respiratory, developmental, rehabilitative and restorative service providers type

CODE: 224900000X Mastectomy fitter classification

Definition: An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services.

TYPE: Individual, respiratory, developmental, rehabilitative and restorative service providers type

CODE: 224L00000X Pedorthist

Definition: An individual who is trained in the management and treatment of conditions of the foot, ankle, and lower extremities requiring fitting, fabricating, and adjusting of pedorthic devices.

Furthermore, seven additional changes were made, including six revisions to existing definitions to the following codes:

222Z00000X
224P00000X
225A00000X
225000000X
333300000X
335E00000X

Finally, code 177F00000X Lodging classification, was moved from its current location, Individual or groups (of individuals) section, to the nonindividual section.

The current version of the Health Care Provider Taxonomy Code Set is version 10.1, 7/10.

Karen Prescott, CPC, CCS-P, CCP Clinical/Technical Editor

Key Terms Provider Taxonomy

 

 
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