Correct Billing for Audiologists
To help ensure appropriate provider reimbursement, it is important for claims to include the appropriate provider taxonomy coding for care rendered by an audiologist.
For the appropriate taxonomy codes, refer to the Audiologist section of the National Uniform Claim Committee’s Health Care Provider Taxonomy Code Set. Please be aware that claims for services rendered by an audiologist that do not include the necessary provider information (as noted below) may be denied.
When completing the professional CMS-1500 form, please note the following:
- Field 24J (Rendering Provider ID #): This field is mandatory and should include the appropriate taxonomy code for the provider rendering care.
- Field 24I (ID Qualifier): Enter ZZ. This code is used to denote that the provider has an NPI and is providing taxonomy information.
For Electronic Claims Submission
When submitting claims electronically (HIPAA 837 Professional files), please provide the following information:
|
Loop ID |
2310B PRV |
|---|---|
|
PRV01 (Code identifying the type of provider) |
PE |
|
PRV02 (Code qualifying the reference identification) |
PXC |
|
PRV03 (Reference Identification) |
Render Provider’s Taxonomy Code |
For more information on submitting 837 professional claims, please refer to the CarePartners of Connecticut Standard 837 Companion Guide. In addition, please refer to CarePartners of Connecticut’s updated Audiology Professional Payment Policy, which has been updated for clarity related to these billing practices.