A taxonomy code is a unique ten-character alphanumeric code that identifies your specialty on claims. Some examples of specialties include Marriage and Family Therapists, Licensed Clinical Social Workers, Speech-Language Pathologists, and Physical Therapists.

In this guide, we'll cover:

• Finding your taxonomy code
• Entering your taxonomy code for claims
• Resolving a rejected claim due to a missing or invalid taxonomy code in box 24j

Finding your taxonomy code

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

Since the requirements for these fields vary by payer, the ZZ qualifier would be 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. 

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 to the insurance payer through the electronic 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:

If the information appears on a downloaded claim, then it’s being sent to the payer electronically. 

If a downloaded claim for a payer that requires a taxonomy code and ZZ qualifier doesn’t appear with these items in box 24, submit a help request to our team. We can work with our clearinghouse to verify the requirement and make any necessary updates to the settings from our end. 

To find your taxonomy code:

• Visit the NPPES NPI Registry
• Enter your NPI Number into the field
• Click Search

Entering your taxonomy code for claims

Typically, a claim will need to reflect the taxonomy code associated with your billing NPI, which may either be an individual or organizational NPI. Certain payers may also require the taxonomy code associated with your rendering provider NPI, which would be your individual NPI.

To enter the taxonomy code associated with your billing NPI:

• Navigate to Settings > Billing and Services > Insurance
• Under Billing Provider Info (Box 33), enter the Taxonomy Code associated with your billing NPI

• Click Save

To enter the taxonomy code associated with your rendering provider NPI:

• Navigate to Settings > My Profile > Clinical 
• Under Clinical Information, enter the Taxonomy Code associated with your individual NPI

• Click Save Information

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

Note: If you’ll be billing under your supervisor's credentials, leaving the NPI Number field blank will trigger the system to pull the taxonomy code entered in your supervisor's settings. For more information on this, see How to bill insurance under your supervisor's credentials. 

Resolving a rejected claim 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 the individual clinician can update their taxonomy code within their Clinical settings.  

To do this: 

• Visit the NPPES NPI Registry
• Enter the clinician’s NPI in the field
• Click Search
• Navigate to Settings > My Profile > Clinical 
• Enter the taxonomy code in the Clinical Information section

• 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
• Select View next to the rejected claim
• Click the trash icon to delete the claim

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 also choose to store downloaded claims in their client’s file.

• 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 rendering provider taxonomy code is populated into box 24j.  

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