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Reminder: Guidelines for billing with taxonomy codes

March 7, 2019

As previously communicated, AmeriHealth requires the use of taxonomy codes to ensure proper claims processing. If a provider's group National Provider Identifier (NPI) is associated with more than one AmeriHealth specialty, the provider must include the appropriate provider taxonomy code in addition to the NPI on all claims. This allows the accurate matching of the provider's agreement(s) with AmeriHealth. Failure to submit claims with the applicable NPI and correct correlating taxonomy code may result in incorrect claims processing and/or payment delays.

The following examples illustrate how to correctly submit your taxonomy code:

Example 1

Incorrect billing practice
Billing NPISpecialty descriptionTaxonomy codeTaxonomy description
12345XXXXXDurable medical equipment332B00000XDurable medical equipment
Rendering NPISpecialty descriptionTaxonomy codeTaxonomy description
11223XXXXXDurable medical equipment333600000XPharmacy
Correct billing practice
Billing NPISpecialty descriptionTaxonomy codeTaxonomy description
12345XXXXXDurable medical equipment332B00000XDurable medical equipment
Rendering NPISpecialty descriptionTaxonomy codeTaxonomy description
11223XXXXXDurable medical equipment332B00000XDurable medical equipment

Example 2

Incorrect billing practice
Billing NPISpecialty descriptionTaxonomy codeTaxonomy description
12345XXXXXHome infusion/Durable medical equipment3336H0001XHome infusion/Durable medical equipment
Rendering NPISpecialty descriptionTaxonomy codeTaxonomy description
11223XXXXXHome infusion/Durable medical equipment333600000XPharmacy
Correct billing practice
Billing NPISpecialty descriptionTaxonomy codeTaxonomy description
12345XXXXXHome infusion/Durable medical equipment3336H0001XHome infusion/Durable medical equipment
Rendering NPISpecialty descriptionTaxonomy codeTaxonomy description
11223XXXXXHome infusion/Durable medical equipment3336H0001XHome infusion/Durable medical equipment
If you have additional questions on billing with taxonomy codes, please email us at providercommunications@amerihealth.com.

 


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