by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Oct 6th, 2021
The National Uniform Billing Guidelines require the use of taxonomy codes for claims submissions on the ADA-Dental claim form and the CMS-1500 Medical Claim form. When reporting the taxonomy code, be sure the provider is contracted with the payer under the taxonomy code being reported. We have listed the general sub-set of taxonomy codes suggested by the ADA, however, the ADA also states, "The general code listed as 'Dentist' may be used instead of any of the other codes."
Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.) licensed by the state to practice dentistry, and practicing within the scope of that license.
Provider | Taxonomy Code |
Dentist |
122300000X |
General Practice | 1223G0001X |
Dental Public Health | 1223D0001X |
Endodontics | 1223E0200X |
Orthodontics | 1223X0400X |
Pediatric Dentistry | 1223P0221X |
Periodontics | 1223P0300X |
Prosthodontics | 1223P0700X |
Oral & Maxillofacial Pathology | 1223P0106X |
Oral & Maxillofacial Radiology | 1223D0008X |
Oral & Maxillofacial Surgery | 1223S0112X |
For a complete list of provider taxonomy codes click here.
Taxonomy codes should be submitted on claim forms as follows:
ADA 2019 claim form
• Box 56a should contain the taxonomy code
CMS-1500 claim form
Rendering Provider
• Box 24i should contain the qualifier ZZ
• Box 24j should contain the taxonomy code
Billing Provider
• Box 33b should contain the qualifier along with the taxonomy code
Referring Provider
• If a referring provider is indicated in box 17 on the claim, then Box 17a should contain the qualifier of ZZ along with the taxonomy code in the next column.
References/Resources
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.