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Proper Taxonomy Code for Ambulatory Surgical Center

National Government Services has been testing new edits to implement into our Advance Communication Engine System Edit Module (NGS-ACE) front end editing. During the testing, we discovered some providers are using the incorrect taxonomy code for ASC.

A taxonomy code is a unique 10-character code that designates your classification and specialization and enables providers to identify their specialty at the claim level.

To date the correct taxonomy code for an ASC is 261QA1903X; per CMS.

CMS created the Medicare Provider and Supplier Taxonomy Crosswalk which is updated and published twice a year, in January and July. This crosswalk links the different types of providers and suppliers with the appropriate Healthcare Provider Taxonomy Codes.

Although the taxonomy code is not required, it is strongly recommended to assist in identifying the PTAN to select in order to adjudicate a claim. It is imperative that when the taxonomy code is reported on a claim it is valid for the specialty billing the service. When not reported, or reported improperly, the following may occur during claims processing:

  • Delay in processing/payment
  • Claim denial
  • Improper payments
  • NGS-ACE edit set improperly 

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Posted 5/5/20203