NUCC taxonomy code selection and mapping for providers

Steps

1. Download or browse the current NUCC Health Care Provider Taxonomy code set from https://www.nucc.org/index.php/code-sets-mainmenu-41/provider-taxonomy-mainmenu-40/code-lookups — the code set is updated twice a year in January and July.
2. Identify the correct code using the three-level hierarchy: Provider Grouping (e.g., Allopathic & Osteopathic Physicians) > Classification (e.g., Internal Medicine) > Specialization (e.g., Cardiovascular Disease).
3. Map your taxonomy code to claims: in the X12 837P professional claim, place the taxonomy code in Loop 2000B NPI/taxonomy for billing provider and Loop 2310B for rendering provider using qualifier ZZ in PRV03.
4. In FHIR resources, represent the taxonomy code in PractitionerRole.specialty using the system http://nucc.org/provider-taxonomy and the 10-character alphanumeric code as the code value.
5. Validate your selected code against the CMS crosswalk at https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/health-care-taxonomy to confirm Medicare recognizes the code for enrollment and billing.
6. When a provider has multiple specialties, select one primary taxonomy for claims; document the primary selection and ensure it matches the primary taxonomy registered in NPPES.