A Message from NCTracks on Behalf of NC Medicaid Adding Billing, Rendering and Attending Provider Taxonomy to Professional and Institutional EDI Claims

Health plans have identified a common billing error of providers submitting professional and institutional EDI claims (ASC X12 837-P and ASC X12 837-I) with missing or invalid billing provider, rendering provider and attending provider taxonomy codes. 

When billing NC Medicaid Direct claims, providers may have directed clearinghouses to append billing provider, rendering provider, or attending provider taxonomy codes to the claims. This process may not have been established for NC Medicaid Managed Care claims being submitted to the prepaid health plans (PHPs), causing these claims to deny for missing or invalid taxonomies.

More information is available in the Medicaid provider bulletin here.