ClaimRev Support Documentation

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====== Taxonomy Code Override ======

Override the provider taxonomy code on claims. Can apply to the billing provider, rendering provider, or both.

**Applies to:** Professional (837P), Institutional (837I), Dental (837D)

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===== When to Use This =====

  * A multi-specialty provider needs different taxonomy codes per payer
  * A payer rejects claims because the taxonomy doesn't match their records
  * You need to override the billing taxonomy without changing the rendering taxonomy (or vice versa)
  * A specific provider's claims always need a particular taxonomy code

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===== Fields =====

^ Field ^ Required ^ Description ^
| Start Date | Yes | When this rule becomes active |
| End Date | No | When this rule expires |
| Payer Number | No | Only apply for a specific payer. Blank = all payers |
| Provider NPI | No | Only apply when this NPI is found on the claim (checks both billing and rendering). Blank = apply regardless of provider |
| New Taxonomy Code | Yes | The taxonomy code to set (e.g., "207Q00000X") |
| Override Billing Taxonomy | No | Check to update the billing provider's taxonomy in Loop 2000A |
| Override Rendering Taxonomy | No | Check to update the rendering provider's taxonomy in Loop 2310B |
| Notes | No | Your reference notes |

**Note:** Check at least one of "Override Billing Taxonomy" or "Override Rendering Taxonomy" — otherwise nothing will change.

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===== Examples =====

=== Example 1: Override Billing Taxonomy for Medicare ===

Medicare requires taxonomy "207Q00000X" (Family Medicine) for the billing provider.

^ Field ^ Value ^
| Payer Number | 00882 |
| New Taxonomy Code | 207Q00000X |
| Override Billing Taxonomy | ✓ Checked |
| Override Rendering Taxonomy | Not checked |

=== Example 2: Override Both for Specific Provider ===

Dr. Smith's claims to Aetna need taxonomy "2084P0800X" (Psychiatry) on both billing and rendering.

^ Field ^ Value ^
| Payer Number | 60054 |
| Provider NPI | 1234567890 |
| New Taxonomy Code | 2084P0800X |
| Override Billing Taxonomy | ✓ Checked |
| Override Rendering Taxonomy | ✓ Checked |

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===== What Happens on the Claim =====

  - If **Override Billing Taxonomy** is checked: updates PRV segment element 3 in Loop 2000A
  - If **Override Rendering Taxonomy** is checked: updates PRV segment element 3 in Loop 2310B (inside Loop 2300)
  - If **Provider NPI** is set: first checks that the NPI appears on either the billing or rendering provider before applying
  - A note is added documenting the change
  - Shows in Applied Validation Modules as "TaxonomyCodeOverrideModule"

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