Claims Processing – Use of Taxonomy Codes with Claim Submissions
Correction to Bulletins BT200702, BT200703, and BT200706: For all provider fields, the taxonomy code is only required if needed to obtain a one-to-one match to the provider’s Legacy Provider Identifier (LPI). For claims received with the billing provider NPI only (no taxonomy), and a one-to-one match cannot be obtained from the NPI and service location ZIP Code+4, the IHCP will return the claim to the provider.
First Steps providers must continue to use the appropriate taxonomy codes when submitting claims to ensure their services are reimbursed correctly. In addition, waiver providers submitting claims with an NPI must not bill a taxonomy code on their claim.