The National Uniform Claim Committee (NUCC) has made changes to its provider taxonomy codes that the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) describes as “mostly positive” for O&P.
Taxonomy codes, also called specialty codes, are an administrative code set for identifying the provider type and area of specialization for healthcare providers. These codes are maintained by NUCC and selected by providers to indicate their specialty area of practice. According to ABC, some payers now request a provider’s taxonomy code to identify the provider’s specialty designation/s during an enrollment process. As the move toward greater utilization of electronic data exchange continues, taxonomy codes have begun to be linked within a provider’s enrollment or re-enrollment, including the process to obtain a National Provider Identifier (NPI) through the National Plan & Provider Enumeration System (NPPES).
“ABC feels it is important to ensure that the taxonomy code descriptions are relevant to the contemporary practice in the profession,” ABC Executive Director Cathy Carter said. To that end, ABC had requested changes to the existing code descriptions for orthotists, prosthetists, mastectomy fitters, and orthotic fitters. It had also launched an effort to establish a specific code for pedorthists, who previously did not have a taxonomy code. “Requesting changes to the descriptions and obtaining a new pedorthist code involved a lengthy process but was something that ABC was absolutely committed to achieving,” Carter said. ABC stated in a press release that through its efforts, a specific code for pedorthists has been added for the first time, and the existing code descriptions for orthotists, prosthetists, and mastectomy and orthotic fitters have been updated to better reflect contemporary practice in these professions. These changes are scheduled to become effective on October 1.
ABC stated that it disagrees with NUCC’s decision not to establish a specific taxonomy code for therapeutic shoe fitters and will resubmit its request at the earliest possible opportunity. ABC also will seek an appeal regarding the language included by NUCC in the orthotic fitter description because it inappropriately includes custom orthoses.
According to ABC, taxonomy codes are self-selected and do not infer an expansion of an individual’s ability to provide certain services.
“ABC believes that taxonomy codes should accurately reflect the nationally recognized scope of practice of credentialed and/or licensed individuals and, for the most part, these changes accomplish that goal,” ABC concluded.
For more information, including a complete listing of all taxonomy codes, visit the National Uniform Claim Committee.
