Courtesy of Jan Root: "Today, it is common for multi-specialty providers to arrange to be paid at different (higher) rates when they bill under certain specialties. Often it is the responsibility of the provider to tell the payer "this particular claim is billed under this (higher paid) specialty." The most common method of communicating this information to the payer is to use a specific payer-assigned provider identifier on the higher paid claims. The provider is assigned X for their 'normal' claims and Y for their (higher paid) specialty claims. The NPI will probably torpedo this method. Each provider only gets one NPI.
"Based on the NPRM for the NPI, it will no longer be possible for a multi-specialty provider to be able to tell a payer when they are billing under their various (higher paid) specialties unless they can send a taxonomy code. Providers will (probably) be able to list all their various specialties in the national provider system, but use of the NPI as the sole method of identifying a provider will make it impossible for them to say "on THIS claim, I'm billing under my (higher paid) specialty of Y." The NPI only identifies the provider - it does not identify which specialty is being used on a particular claim. Proprietary specialty codes are not allowed. Payer-assigned provider IDs will (probably) not be allowed. What's the provider going to do?" See http://www.wpc-edi.com/conferences/HC_Archive/All.pdf. William J. Kammerer Novannet, LLC. Columbus, US-OH 43221-3859 +1 (614) 487-0320 ----- Original Message ----- From: "Doug Webb" <[EMAIL PROTECTED]> To: "WEDI SNIP Transactions Workgroup List" <[EMAIL PROTECTED]> Sent: Tuesday, 12 November, 2002 10:05 AM Subject: Re: Taxonomy Codes Marshal - I think that that would happen if the NPI database makes the inclusion of a separate code redundant. A policy such as this would not require a change to the IGs, since the Addenda make the Taxonomy codes Situational. If the database includes the information, the Situation could be declared (in the NPI rule) to never apply. If this does come to pass, then I would expect the taxonomy codes to be eliminated in the next iteration of specs (eliminating a never-used segment). The opinions expressed here are my own and not necessarily the opinion of LCMH. Douglas M. Webb Computer System Engineer Little Company of Mary Hospital & Health Care Centers [EMAIL PROTECTED] ----- Original Message ----- From: "Marshall E. Fryman" <[EMAIL PROTECTED]> To: "WEDI SNIP Transactions Workgroup List" <[EMAIL PROTECTED]> Cc: <[EMAIL PROTECTED]> Sent: Tuesday, 12 November, 2002 09:49 AM Subject: RE: Taxonomy Codes I was told by a Medicare rep that the Taxonomy Codes would be discontinued with the implementation of NPI. I have no idea where she got that information, but she is a manager of the EDI department and it was at an EDI seminar, so it may be accurate. Marshall --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [email protected] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
