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)

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

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.

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

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

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”