What are provider specialty codes?
–Specialty codes are self-designated and describe the kind of medicine physicians, non-physician practitioners or other healthcare providers/suppliers practice. Appropriate use of specialty codes helps reduce inappropriate suspensions and improves the quality of utilization data.
What is a provider type code?
A code describing the type of provider (i.e. doctor or facility) responsible for treating a patient. This represents the attending physician if available. If the state uses state-specific codes, they should map their internal codes to the CMS standard list provided.
What are physician service codes?
CPT codes are physician procedure codes, found in Current Procedural Terminology, published by the American Medical Association. The codes dictate the work done for payment purposes.
What are the 5 code sets approved by Hipaa?
UNIFORM CODE SETS
- International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM).
- Current Procedural Terminology.
- HCFA Common Procedure Coding System (HCPCS).
- Code on Dental Procedures and Nomenclature.
- National Drug Codes (NDC).
What are specialty providers?
Specialty Provider means a provider who provides specialized services. The term also can be used to describe a facility offering specialized services (e.g., cancer center).
What does provider specialty mean?
The provider’s specialty is a value indicating what field of medicine a provider has additional education in to make him/her a specialist in a certain field.
What is a specialty taxonomy code?
A taxonomy code is a unique 10-character code that designates your classification and specialization. You will use this code when applying for a National Provider Identifier, commonly referred to as an NPI.
What is HIPAA EDI transactions?
Under the HIPAA EDI rule, a HIPAA electronic transaction is an electronic exchange of information between two parties to carry out financial or administrative activities related to healthcare. For example, a healthcare provider will send a claim to a health plan to request payment for medical services.
What are HIPAA transactions?
A HIPAA transaction is an exchange of electronic information between two Covered Entities to carry out financial or administrative activities related to healthcare. A good example would be when a healthcare provider sends a claim to a health plan to request payment for services.
What is specialty taxonomy code?
A taxonomy code is a unique 10-character code that designates your classification and specialization. You will use this code when applying for a National Provider Identifier, commonly referred to as an NPI. To enroll, you must have an NPI.
What are the Revenue Codes for clinic services?
2. Revenue Codes 0510 – 0519 Clinic Clinic charges (revenue codes 0510 – 0519) are facility fee split billing of clinic -based services. This split billing is not allowed, and revenue codes 0510 – 0519 are not reimbursable; charges will deny to facility/provider write-off. Participating providers and facilities may not balance-bill the
What is the meaning of specialty code 70?
specialty code 70: A multi-specialty group (193200000X) is a business group of one or more individual practitioners who practice within different areas of specialization. A single specialty group (193400000X) is a business group of one or more individual practitioners, all of who practice within the same area of specialization.
What are the specialty codes for Medicare providers?
Medicare provider/supplier specialty codes. Here is the list of Medicare provider/supplier specialty codes you can use as a reference during the enrollment process. Code. Description. 01. General practice. 02. General surgery. 03. Allergy/immunology. 04. Otolaryngology. 05. Anesthesiology. 06. Cardiology. 07.
What do you need to know about specialty codes?
General Requirements.–Specialty codes are self-designated and describe the kind of medicine physicians, non-physician practitioners or other healthcare providers/suppliers practice. Appropriate use of specialty codes helps reduce inappropriate suspensions and improves the quality of utilization data.
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