Taxonomy Codes Master File

File Maintenance Help for NextGen® Enterprise 8

Taxonomy Codes Master File

To meet HIPAA requirements, a Taxonomy code may be required by some payers. Taxonomy codes are maintained at the Enterprise level in the Taxonomy master files and they are attached to the provider in the Provider Master. Taxonomy codes classify health care providers according to provider type or practitioner specialty in an electronic environment. The codes that: Are pre-loaded in the Taxonomy Code field in the Provider master file do not display in the Taxonomy master file, so they cannot be edited or hidden. Display in the Taxonomy master file are those that you create and can be edited or hidden. Note: The taxonomy code set is maintained by the National Uniform Claim Committee (NUCC). Refer to the http://www.nucc.org web site for information on maintaining the current taxonomy code set for your enterprise or practice. Parent topic: Taxonomy Codes

File Maintenance Help for NextGen® Enterprise 8

Taxonomy Codes

The Healthcare Provider Taxonomy codes are a HIPAA standard code set named in the implementation specifications for some of the ASC X12N standard HIPAA transactions. The Healthcare Provider Taxonomy Code (HPTC) is a situational data element in the ANSI X12N Implementation Guides for the 837 4010A1 Institutional and Professional claims or equivalent encounter information transactions. If the taxonomy code is required in order to properly pay or process a claim or equivalent encounter information transaction, it must be reported. Thus, reporting of the Healthcare Provider Taxonomy Code varies among health plans. 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 code consists of two parts: individuals (such as physicians) and non-individuals (such asNextGen® Enterprise health care facilities). All codes are alphanumeric and are 10 characters in l

Help Guide for NextGen® Enterprise PM 8

Attaching Taxonomy Codes

You can attach taxonomy codes to: Providers as the provider default taxonomy code for the enterprise Providers at the practice level, which overrides the provider default taxonomy code Providers at the CPT4 level, which overrides the practice level taxonomy code Locations Groups as the group default taxonomy code Groups at the location level, which overrides the group default taxonomy code Groups at the CPT4 level, which overrides the group location level taxonomy code Payers at the practice/UB level, which overrides the group level taxonomy code Payers at the alternate payer level, which overrides the group level taxonomy code DME Regions at the CPT4 level Parent topic: Taxonomy Codes Master File

Help Guide for NextGen® Enterprise PM 8

Set Up and Maintain a Taxonomy Code List

From the Master Files - System list, select Taxonomy Codes. The Taxonomy Codes List window opens. From the Taxonomy Codes List window, do one of the following: To add a new item, select the open menu button, and then select New. To modify an item, enter an asterisk (*) in the Taxonomy Codes List Search field to list existing records. Select an item in the list, select the open menu button, and then select Open. The Taxonomy Information window opens. Enter the taxonomy code in the Taxonomy Code field. This code populates to the 837 file. Enter the taxonomy description in the Taxonomy Description field. This description displays in the Taxonomy Code field in the Provider master file. If you want the referring physician name to print in the supervisor loop (2310E) when the referring physician is on a claim and is using this taxonomy code, enable the Print referring info in 2310E check box. In the Note field, enter any additional notes if needed. Select OK. Parent topic: Taxonomy Codes Mas

Help Guide for NextGen® Enterprise PM 8

Run a Provider Taxonomy Code Report

You can report on the taxonomy codes attached to providers by using the Taxonomy filter column on the Master File Provider Information Listing report. In File Maintenance, select Master Files - System > Providers. Select the open menu button, and select Print > All Providers. Parent topic: Taxonomy Codes Master File

File Maintenance Help for NextGen® Enterprise 8

Attach Taxonomy Codes to Providers

You can attach taxonomy codes to: providers as the provider default taxonomy code for the enterprise. providers at the practice level, which overrides the provider default taxonomy code. You can add taxonomy codes at this level by location on the payer rows, either default or specific. The most specific setting is always selected above the other settings. Note: If the provider has a different taxonomy code for different service locations and payers, then the taxonomy code must be attached for each service location and payer. To attach a default taxonomy code for the provider: From the Master Files list, select System or PM > Providers. Select the provider. Select the System tab. Select the taxonomy code from the Taxonomy Code field. Attach a Taxonomy Code for the Provider at the Practice Level Parent topic: Taxonomy Codes

Taxonomy Codes Master File

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