Add or Remove Billing Provider Taxonomy Code

This rule will instruct the system when to add or remove the billing provider's taxonomy code on a claim. 

Workflow

Let's review how to create a claim rule to add or remove the billing provider's taxonomy code!

• 1. Navigate to Management Center > Claim Rules.
     
     
  2. Click Create Claim Form  Rule.
     
  3. Select the Practice.
     
  4. Next, give the rule a name.
  5. Update the Claim Type to Institutional or Professional.
     
  6. Select Conditions to create criteria a claim should meet before the rule will apply.
     
  7. Next, click on the Behaviors dropdown.
  8. Select Billing Provider - Taxonomy Code
     
     
  9. Next, click Add.
     
  10. Update the dropdown to one of the following choices:
      1. Omit to create the claim without the Billing Provider Taxonomy when present.
      2. Require and Write to Claim to always require the Billing Provider Taxonomy. 
      3. Write to Claim if Present to only include the Billing Provider Taxonomy when that information is included in Insurance Billing or Rendering Provider profile. 
         
  11. To create multiple behaviors, repeat steps 7-10.
  12. Click Save to complete the process.
       

Box Number(s)

• UB-04: Box 81CCa - Taxonomy Code and Qualifier 
• CMS-1500: Box 33b - Other ID Number

Helpful Hints

• If one of your conditions is payer-based, select Current Sequence Behavioral instead of the Primary Behavioral Payer. This will ensure the rule applies to secondary and tertiary claims when needed. 
• To read more about how to set claim rule conditions and order, see the Claim Rule: Setting Claim Rule Conditions article.
• To read more about how to set up a claim rule to be effective as of a certain date, see the Scheduled Change Sets article.