DEC 05, 2022
3 Reasons to Confirm Designated Taxonomy Codes Are Correct
Q. How should taxonomy codes be designed for ophthalmologists and why is it important?
A. Here are three reasons to confirm designated taxonomy codes are correct and a link to the instructions per specialty:
CMS Data Analysis
The Centers for Medicare & Medicaid Services (CMS) uses the taxonomy codes to aggregate claim data for ophthalmologists and utilizes it in Merit-Based Incentive Payment System (MIPS) scoring. Additionally, they can appropriately define “peers” to which it compares ophthalmologists.
Payer Contract Pricing
Appropriate taxonomy codes contribute to physician specialty contract pricing for payers even outside of Medicare and Medicaid. These codes can identify unique drug utilization for ophthalmology and other contract-related considerations.
Regardless of subspecialty, all ophthalmologists should confirm taxonomy codes linked to their National Provider Identifier (NPI) have a primary ophthalmology taxonomy code (207W00000X) and update any ophthalmic subspecialty taxonomy code as secondary. This is a crucial step to confirm that the NPI is designated as ophthalmology and not another specialty in medicine or as a student.
You can review detailed instructions at aao.org/taxonomy.