Be sure to use the correct provider taxonomy code to avoid payment delays

We use taxonomy codes to assist in the identification of a provider when they're using one NPI for several Blue Cross Blue Shield of Michigan provider IDs.

Blue Cross and Blue Care Network claims payment systems don’t use every taxonomy code listed in the National Uniform Claim Committee, or NUCC, code set list. In the enrollment and credentialing process, if you submit a taxonomy code that we don’t use, we’ll change it to a higher-level taxonomy code. You must use the Blue Cross- and BCN-assigned taxonomy code during the billing process to avoid possible payment delays. This applies to both Blue Cross and BCN commercial and Medicare Advantage plans.

Taxonomy codes designate your provider specialty. To find the provider taxonomy code you’re required to use when submitting electronic claims to Blue Cross and BCN, refer to these documents located on bcbsm.com:

• Taxonomy Code Mapping — Facility Providers
• Taxonomy Code Mapping — Professional Providers

Here are some examples:

• If you’re submitting a claim for a family practice physician, you use taxonomy code 207Q00000X. This code is listed on the Taxonomy Code Mapping — Professional Providers document, so there is likely no change from what was submitted during the enrollment and credentialing process.

• If you’re submitting a claim for a pediatric cardiologist, you won't find that specialty listed on the Taxonomy Code Mapping — Professional Providers document. As a result, you’ll need to use the higher-level taxonomy code for pediatrics, 208000000X, even if that isn't the code that was submitted during the enrollment and credentialing process.