Hi Kathy, No one knows about the requirements for October 2003. The Addenda to the Transactions and Code Sets should be published in the Federal Register within 48 hours. The Addenda relax the requirement for taxonomy codes by making them situational. The situation is "Required when adjudication is known to be impacted by the provider taxonomy code ..." I believe that many of the State Medicaid agencies have planned to use the provider taxonomy code and would "require" it. It appears that Medicare does not need the taxonomy code.
The soon-to-be-published Addenda are a proposal only. Once published, there will be a comment period (probably 30 days) followed by some time to digest and act on the comments. Then DHHS will publish a Final Rule, and Congress will have some time (30 days? 60 days?) to consider any changes to the Final Rule. Once the Congressional period has passed, the implementation period must be no less than 180 days. If there are no outlandish delays in the process, this leaves sufficient time to publish the Final Rule for the Addenda and have them become effective by October 2003. (There are way too many conditional phrases in the above -- I'll have to turn in my programmer's card!) In summary, it is possible that some health plans will "require" the provider taxonomy code by October 2003. My personal opinion is that this will vary from one payer to the next. Medicaid plans will generally require the taxonomy code; most other health plans will not want it. Hope this helps. Tom Drinkard > -----Original Message----- > From: Carlin, Kathy (Contractor) [mailto:[EMAIL PROTECTED]] > Sent: Wednesday, May 29, 2002 9:33 PM > To: 'Tom Drinkard' > Cc: [EMAIL PROTECTED]; Valdiviezo, Nora > Subject: Taxonomy Codes > > Hi Tom, > > Thanks for getting back to me so quickly. Could you please clarify one > point? When Medicare relaxes the requirement for the taxonomy codes, is > this just until the HIPAA requirements are fully implemented in October > 2003 or are they permanently relaxing the taxonomy code requirement? In > other words, does this mean the providers can send 837 claims to Medicare > without taxonomy codes but only until October 2003? > > As I am sure you know, collecting and creating systems support for > taxonomy codes will be tremendous undertaking especially for referring > providers. Therefore, it is critical to know if this will be a required > component by Medicare come October 2003. I understand that we would need > to confirm with each payer whether they would be requiring taxonomy codes > or not. I suspect that most payers will follow Medicare. > > Thanks again for your help. > > Kathy > > -----Original Message----- > From: Tom Drinkard [mailto:[EMAIL PROTECTED]] > Sent: Wednesday, May 29, 2002 6:22 PM > To: Carlin, Kathy (Contractor); [EMAIL PROTECTED] > Subject: RE: Taxonomy Codes > > Hi Kathy, > Medicare has filed (or will soon be filing) for an extension to the > deadline for compliance with the Transactions and Code Sets Final Rule. > By applying for and receiving the extension, they do not have to follow > the implementation guides as published in May 2000. > Medicare has announced their intention to relax the requirement for > provider taxonomy codes and to allow the HCPCS J-codes for prescription > drugs. > > Other payers could elect to stick to the October 2002 deadline. Those > that choose to do so will require the taxonomy codes. My guess is that > there will not be many payers who will meet and require the October 2002 > deadline, however. You should check with your trading partners in any > event. > > Hope this helps. > Tom Drinkard > > -----Original Message----- > From: Carlin, Kathy (Contractor) [mailto:[EMAIL PROTECTED]] > Sent: Wednesday, May 29, 2002 9:15 PM > To: 'Tom Drinkard'; [EMAIL PROTECTED] > Subject: RE: Taxonomy Codes > > Hi Tom, > > I read that Medicare is not going to require the taxonomy codes. Do > you know if this is correct? If the payers don't require them, will they > still be required on the 837 claims? > > -----Original Message----- > From: Tom Drinkard [mailto:[EMAIL PROTECTED]] > Sent: Tuesday, May 28, 2002 9:01 PM > To: [EMAIL PROTECTED] > Subject: RE: Taxonomy Codes > > Sharon, > The National Uniform Claim Committee (NUCC) administers the Provider > Taxonomy Codes. > You can read about their history and background at > http://www.nucc.org/Taxonomy/index.html > For further information, including the format, structure of the > codes and the recently published update, go to > http://www.wpc-edi.com/codes/Codes.asp and select "Provider Taxonomy > Codes". > > Hope this helps. > Tom Drinkard > EDIT, Inc. > > -----Original Message----- > From: sharon cox [mailto:[EMAIL PROTECTED]] > Sent: Tuesday, May 28, 2002 1:39 PM > To: [EMAIL PROTECTED] > Subject: Taxamony Codes > > Do you have any information about the taxonomy code? > 1. Has is been adopted? > 2. What is its length? > 3. What are valid characters? > 4. Does it have any punctuation for display purposes > (like SSN, for example) > > > Sharon
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