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Help needed for taxonomy choice

  1. #1
    Question Help needed for taxonomy choice
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    Hi, we've been informed of changing in billing specifications by Wellcare Health Plans, requiring putting in a ten-character taxonomy code in box 24j of form 1500.

    Now our office has two providers sharing the same tax id. shall we choose a code for "group practice" (208D00000X) as a common code for both doctors , or shall we choose a taxonomy code for each doctor respectively: one for internal medicine(207R00000X) and one for pediatrics (208000000X)?

    Timely help will be greatly appreciated.

  2. #2
    Milwaukee WI
    Default Individual specialty
    If you are billing for professional services, I would choose the taxonomy for the individual provider's specialty.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    I would choose the specialty specific ones. Not sure if your doctors see the same patients or refer back and forth to each other, but having specialty taxonomy codes will help with any denials you might get if the patient is seen in the hospital on the same day by both of your providers or if one refers to the other and you charge a new pt visit and the insurance denies saying they should be established. Just a thought.

    Hope this helps!
    Susie Corrado, CPC
    ENT Coding/Billing

  4. #4
    Thanks a lot for your quick response, Tessa and Susie! I appreciate that.
    We'll go with the individual specialty as you advised.

    Have a nice day!


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