Dental-Provider Specialty Taxonomy Codes
October 6th, 2021 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
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.
|Dental Public Health
|Oral & Maxillofacial Pathology
|Oral & Maxillofacial Radiology
|Oral & Maxillofacial Surgery
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
• Box 24i should contain the qualifier ZZ
• Box 24j should contain the taxonomy code
• Box 33b should contain the qualifier along with the taxonomy code
• 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.
If you have questions or comments about this article please contact us. Comments that provide additional related information may be added here by our Editors.
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