CMS Taxonomy Codes

[DrSwede]

I was recently asked which Taxonomy code I would be identified with by my administrators.

I have no frame of reference for this whatsoever, but I did find this document.

So, given that I am PM&R and Pain Medicine Fellowship trained, would I be under 2081P2900X or 208VP0000X ?

Another search for those codes made it sound like the latter description was more appropriate, but I am not exactly sure how these codes are used.

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[ampaphb]

I agree. Go with the latter. The reason these are important is that this is the peer group you will be compared with when Medicare looks at your benchmarks. Do you do more tf-esi's than the national average. If they're comparing you to a general pm&r guy who does three epidurals a month, you will be seen to be over utilizing.

 

[Taus]

If you do emg's you need to be careful if it's not PMR. Some colleagues have had billing issues.


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[DrSwede]

Sorry to resurrect this again, but still having issues believe it or not.

The taxonomy code that I have documented on NPPES website & Athena (our EMR) is 208VP0000X - Pain Medicine Pain Medicine. The people in my organization are working on my Texas Medicaid application, and are stating the code that is listed on NPPES website (and thus Athena) is not a recognized taxonomy code for my provider type (DO).

My colleague who is an MD has the following codes:

• Primary taxonomy - 208VP0014X - Pain Medicine Interventional Pain Medicine
• Secondary Taxonomy - 2081P2900X - Physical Medicine & Rehabilitation Pain Medicine

Basically they must have a 3 way match between Athena, NPPES, and Texas Medicaid for any Medicaid claims to pay. Otherwise all Medicaid payers will reject if there is not a 3 way match.

Once again, make any difference if I list 2081P2900X as the primary taxonomy? That's essentially the only option I am presented with by my organization. (There are no other DO pain medicine physicians in this organization btw)

 

[bedrock]

I have nothing to contribute other than this is yet another reason not to take Medicaid.

 

[SeniorWrangler]

How do you find out what your taxonomy code is? I have no friggin' idea. I assume I would have heard by now if there was some huge billing issue, but...
There are some nonspecific codes like 208VP0014X which just says interventional pain medicine, can you use that one?

 

[DrSwede]

No, I can't based on Texas Medicaid not allowing it for DO's, but MD's only.