Community

Rendering provider's taxonomy code: Box 24j

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

Because the requirement for these fields will vary from payer to payer, this is a setting that gets enabled from our Administrative backend. After a payer's requirement is verified, our team will turn on these fields for all claims created for the specific payer IDs that require it.   

Important: This setting is enabled based on the payer ID of the payer that is listed in the client's Billing and Insurance tab found by going to the client's Overview page and clicking Edit Details > Billing and Insurance tab. If a claim is manually edited to list a certain payer ID in box 1 before submitting, the taxonomy code cannot be included in box 24j of the claim regardless of the settings on our end.

FAQs


Why can't I view the rendering provider's taxonomy code in box 24j of my claim submission?

This is a feature that gets enabled from our end when claims are created for a specific set of payers. This means that you won't be able to view or edit these fields in the claim preview of your SimplePractice account.

If you'd like to review the information that gets sent to the payer, you can download the PDF version of claim. Upon opening the downloaded PDF, you'll see whether or not the rendering provider's taxonomy code was listed in box 24j.

Note: The taxonomy code that gets populated into box 24j of the claims that require it will pull from the rendering provider's SimplePractice account settings under: My Account > Settings > Basic Info > Clinical Info > Taxonomy code.

If you are viewing a downloaded claim and the taxonomy code did not populate in box 24j, but you believe that the payer you're billing requires it, reach out 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. 


My Claim was rejected due to a missing or invalid taxonomy code in box 24j. How can I fix this?

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

Tip: Refer to this guide if you're having trouble determining what the clinician's taxonomy code is: How do I find my taxonomy code?

You can navigate to this setting by going to My Account > Settings > Basic Info > Clinical Info > Taxonomy code.Enter the correct Taxonomy Code in Clinical Info

Next, you will need to delete the existing claim and create a brand new claim to have the updated settings auto-populate.

Important: Before deleting any claims from your account, we recommend taking note of any associated reference numbers in case a corrected claim needs to be submitted, or in case there are any issues with the payer's Timely Filing requirements.

You can then download the new claim to view the taxonomy code that populated into box 24j. 



I updated my settings, why is the claim still getting rejected due to an invalid taxonomy code in 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 in to effect on the claim.

Before deleting any claims from your account, we recommend taking note of any associated reference numbers in case a corrected claim needs to be submitted, or in case there are any issues with the payer's Timely Filing requirements.

Have more questions? Submit a request