Maureen I cannot answer for Academic Medical Centers, but I hope everyone here understands why the Taxonomy codes were included in the implementation guides in the first place. They are primarily there for when the National Provider Identifier (NPI) is mandated.
If the final NPI rule more or less follows the proposed rule, the NPI will not carry specialty information, at least not from a billing perspective. The NPS (national provider system) will (I think) have a place to list a provider's specialities (does anyone know if that has changed?), but each 'warm body' gets only one NPI and that number as no intelligence built into it. Currently it is common for providers who have more than one specialty, to be allowed (by contractual agreement) to be paid at different rates for their various specialities. For example, a surgeon who has a specialty in neurosurgery is likely to have contractual agreements with various payers to be paid at a higher rate for their neurosurgery claims (as opposed to their regular surgery claims). Currently this distinction is often accomplished through the use of different payer-assigned provider identifiers. With the advent of the NPI, each warm body gets only one NPI and it has no specialty information.... so there goes your common method of distinquishing these claims. Hence, the Provider Taxonomy Code. The idea was that, in situations where providers are getting paid different rates depending on their specialty, the provider taxonomy code would take the place of the payer-assigned provider IDs. This will greatly simplify the provider numbering system for billers. Instead of having dozens of payer-assigned provider IDs, each 'warm body' provider will have an NPI and (if applicable) their specialty/taxonomy codes. And these (hopefully) will work to identify these billing situations for ALL payers. If you have situations where providers are paid different rates by specialty, and the NPI final rule is issued, then you definitely want to sit down with your payers and specify payment rates by taxonomy codes rather than payer-assigned provider identifiers. As we all know, the implementation of the NPI has been delayed (no $$ for the NPS). However, HHS is now saying that funding for the NPS has been included in the President's budget and it looks like funding will be available come October 1, 2002. So, to get back to your original question, the taxonomy codes are (probably) mostly of little use currently, but I expect them to become quite important when the NPI is implemented, at least for those billing situations where specialty is an issue in payment. I hope this is of use and that I'm not 'preaching to the choir' here.... Jan Root "Kirk-Detberner, Maureen" wrote: > I work for an Academic Medical Center. I would like to know what others are > doing with the Taxonomy Code issue. Are you assuming that the Taxonomy > Codes will become situational and doing nothing? Are you contacting your > payors to see if they will be requiring Taxonomy Codes? Or are you building > the Taxonomy Codes in your systems without waiting to see what happens with > the Addenda? > > Maureen Kirk-Detberner > > ********************************************************************** > To be removed from this list, send a message to: [EMAIL PROTECTED] > Please note that it may take up to 72 hours to process your request. ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request.
