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How do I find my taxonomy code?

How do I find my taxonomy code?

A taxonomy code is a unique ten-character alphanumeric code that enables you to identify your specialty (i.e., Speech-Language Pathologist, Physical Therapist, etc.) to an insurance payer on your claims. This guide will provide instructions on how to identify your taxonomy code, as well as where that information should be entered in SimplePractice. 

In this guide, we'll cover:


Finding your taxonomy code

Certain payers require that the rendering provider’s taxonomy code is listed in Box 24j of claim submissions. If a payer requires this, they’ll also require that the ZZ qualifier is listed in Box 24i

Since the requirement for these fields varies by payer, the ZZ qualifier is a setting that gets enabled from our administrative backend. Once it’s enabled, the taxonomy code will populate all claims created for the specific payer ID that requires it. 

Important: The ZZ qualifier (Box 24i) and the rendering provider’s taxonomy code (Box 24j) won’t appear on an electronic claim. However, this information is sent on the claim’s backend. If you’d like to review the information that gets sent to the payer, you can download the PDF version of the claim. Here’s what this section looks like on a downloaded claim: box24.simplepractice.cms1500.png

If the information appears on a downloaded claim, then it’s being sent to the payer electronically. If you’re viewing a downloaded claim and the taxonomy code and ZZ qualifier didn’t populate in Box 24, but you believe that the payer you're billing requires it, submit a help request to our team. We can then work with our clearinghouse to verify the requirement and make any necessary updates to the settings from our end. 

To find your taxonomy code:

Use your NPI Number to find your taxonomy code in SimplePractice


Entering your taxonomy code in SimplePractice

After you've identified the taxonomy code associated with the NPI you're using in SimplePractice, you'll want to make sure to enter that code in the following sections of your account:

  • Navigate to Settings > My Profile > Clinical 
  • Enter the Taxonomy Code associated with your individual NPI under Clinical Information:

taxonomycode.simplepractice.myprofile.png

  • Click Save Information

Our system will automatically populate the taxonomy code you enter in the above section into Box 24j for payers that require that you include it. However, because the rendering provider taxonomy code isn't required by all payers, it's not visible unless you download the claim form.

To populate your taxonomy code into Box 33:

  • Navigate to Settings > Billing and Services > Insurance
  • Enter the Taxonomy Code associated with your NPI under Billing Provider Info

taxonomybox33.simplepractice.insurancebilling.png 

Note: If you're billing insurance as a Group practice, see How to switch from a solo practice to a group practice for insurance billing?


My claim was rejected due to a missing or invalid taxonomy code in Box 24j

If you receive a claim rejection for a missing or invalid taxonomy code in box 24j, you'll want to first check in the clinician's account settings to make sure that the correct taxonomy code was entered in the appropriate field.

Note: If you're part of a group practice, only an individual clinician can update their taxonomy code within the Clinical settings.  

To do this: 

taxonomycode.simplepractice.clinical.jpg

  • Click Save Information

Next, you'll need to delete the existing claim and create a new claim to have the updated settings auto-populate. To do this: 

  • Navigate to Insurance > Claims
  • Open the rejected claim
  • Click the trash icon to delete the claim:

delete.simplepractice.claim.png

 

Important: Before deleting any claims from your account, we recommend downloading the claim and saving the clearinghouse reference number. Saving this information is beneficial in case issues of timely filing arise. Many of our customers choose to store downloaded claims in their client’s file. See How do I store client documents? for more information. 

  • Navigate to Insurance > Unbilled Appointments
    • Any dates of service that were on the deleted claim will now be free to include on a new claim
  • Create and submit the new claim

Tip: You can download the new claim before submitting it to confirm that the correct taxonomy code is populated into Box 24j.  

If a claim was created before your taxonomy code was updated in your account settings, you'll need to recreate the claim in order for the changes to go into effect on the claim, even if it wasn't submitted. 

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