Provider Taxonomy
Provider Taxonomy describes an external code set maintained by the National Uniform Claim Committee (NUCC), a standard setting organization named by the Administrative Simplification subtitle of HIPAA.
Standardized Data Set
Background
The NUCC was created to develop a standardized data set for use by the non-institutional health care community to transmit claim and encounter information to and from all third-party payers. It is chaired by the American Medical Association (AMA), with the Health Care Financing Administration (HCFA) as a critical partner. The Committee includes representation from key provider and payer organizations, as well as standards setting organizations, state and federal regulators and the NUBC.
HIPAA
The NUCC was formally named in the administrative simplification section of the HIPAA of 1996 as one of the organizations to be consulted by the American National Standards Institute's accredited SDOs and the Secretary of HHS as they develop, adopt, or modify national standards for health care transactions. As such, the NUCC is intended to have an authoritative voice regarding national standard content and data definitions for non-institutional health care claims in the United States. The NUCC's recommendations in this area are explicitly designed to complement and expedite the work of the Accredited Standards Committee Electronic Data Interchange (ASC X12N) in complying with the provisions of P.L. 104-191.
EDI
The NUCC is comprised of the key parties affected by health care electronic data interchange (EDI) - those at either end of a health care transaction, generally payers and providers. In addition, the NUCC includes representatives of SDOs, regulatory agencies and the NUBC. Criteria for membership include a national scope and representation of a unique constituency affected by health care EDI, with an emphasis on maintaining or enhancing the provider/payer balance in the original NUCC composition. Each Committee member is intended to represent the perspective of the sponsoring organization and the applicable constituency. Representatives are responsible for communicating information between the Committee and the group(s) they represent.
© Copyright 1997-2002 American Medical Association
Copyright for the members of the National Uniform Claim Committee (NUCC) by the American Medical Association (AMA). Permission is granted to any individual to copy and distribute this material as long as this copyright statement is included, the contents are not changed, and the copies are not sold or licensed. Applicable FARS/DFARS restrictions apply.
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Structure
The taxonomy code is a ten-digit, alphanumeric code defined by the following structure: AABBCCCCCD. The AA portion of the code designates a broad category of service or provider type such as Allopathic & Osteopathic Physician or Hospital. The BB characters further define the code into a classification such as Anesthesiology or Internal Medicine. The CCCCC portion additionally defines a specialty such as Allergy & Immunology or Nephrology within the classification of Internal Medicine. The tenth digit, the D portion, is reserved for future use.
Examples:
- The taxonomy code for an Internist practicing the Nephrology specialty would be 207RN0300X. 20 - Physician, 7R - Internal Medicine, N0300 - Nephrology, and X for future use.
- The taxonomy code for a Rural General Acute Care Hospital would be 282NR1301X. 28 - Hospital, 2N - General Acute Care Hospital, R1301 - Rural, and X for future use.
- Providers (individual, group, or institution) may have one or more than one taxonomy code associated with their practice or organization.
Maintenance Organization
Requests for new codes can be submitted through the National Uniform Claim Committee (NUCC). Requirements and procedures for requesting a new code can be found on the NUCC web site.
Taxonomy Code List and Definitions
Additional information about provider taxonomy can be obtained at the Washington Publishing Company web site.
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