As we prepare to move to our next generation platform in January 2024, we want to advise you of some additional requirements related to the use of taxonomy codes.
Providers should work with their third-party billing agency and/or clearinghouse to ensure compliance with these requirements.
As of January 1, 2024, we require the use of taxonomy codes to ensure proper claims processing and payment. This allows for the accurate application of specialty-driven policies and matching of the provider's agreement(s) with Independence Blue Cross.
Failure to submit claims with the applicable NPI and correct correlating taxonomy code will result in claim denials that must be corrected prior to payment consideration.
Professional claims
When billing professional claims, the appropriate taxonomy code must be entered in the segments indicated below. Do not leave blank.
Electronic claims (837P)
- Loop 2000A/Segment PRV = Billing Provider taxonomy code
- Loop 2310B/Segment PRV = Rendering Provider taxonomy code
- Loop 2420A/Segment PRV = Rendering Provider taxonomy code (when different from what is reported at the claim level)
Paper claims (CMS-1500)
- Box 19 = Billing Provider taxonomy code along with the ZZ qualifier
- Box 24I (shaded) = ZZ qualifier
- Box 24J (shaded) = Rendering Provider taxonomy code
Institutional claims
When billing institutional claims, the appropriate taxonomy code must be entered in the segments indicated below. Do not leave blank.
Electronic claims (837I)
- Loop 2000A/Segment PRV = Billing Provider taxonomy code
Paper claims (UB-04)
- Field 81 = Billing Provider taxonomy code along with the B3 qualifier
Please reference the CMS-1500 and UB-04 Claims submission guides for more information. The CMS-1500 guide will be updated to reflect these requirements in the coming weeks.
We encourage you to frequently visit our dedicated Platform Transition page to stay up to date on the upcoming changes.