Claim edit: Invalid taxonomy code

Stedi now rejects 837P professional, 837D dental, and 837I institutional claims that include a health care provider taxonomy code with an invalid format.

How the edit works

A taxonomy code identifies a provider's classification and specialization, such as cardiology or orthodontics.

Taxonomy codes are defined by the National Uniform Claim Committee (NUCC) and follow a strict format: exactly 10 alphanumeric characters, ending with the letter X.

If a claim contains a taxonomy code that doesn’t follow the format, the payer may reject the claim.

This edit catches the issue before the claim reaches the payer. It prevents payer rejections, which are slower and delay payment for the provider.

Rejection errors

If you submit a claim using Stedi's Claim Submission API endpoints and the claim fails the edit, you'll get back an error response in real time. The response includes details in the errors array:

{
  "errors": [
    {
      "code": "33",
      "description": "Invalid Taxonomy Code. The taxonomy code for Billing Provider does not meet the required format. Taxonomy codes must be 10 alphanumeric characters ending with 'X'. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

{
  "errors": [
    {
      "code": "33",
      "description": "Invalid Taxonomy Code. The taxonomy code for Billing Provider does not meet the required format. Taxonomy codes must be 10 alphanumeric characters ending with 'X'. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

{
  "errors": [
    {
      "code": "33",
      "description": "Invalid Taxonomy Code. The taxonomy code for Billing Provider does not meet the required format. Taxonomy codes must be 10 alphanumeric characters ending with 'X'. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

If you submit a claim using SFTP and the claim fails the edit, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will include a related claim status category code, claim status code, entity identifier code, and error message:

STC*A7>145>85*[DATE]*U*[AMOUNT]******A7>569**Invalid Taxonomy Code. The taxonomy code for Billing Provider does not meet the required format. Taxonomy codes must be 10 alphanumeric characters ending with 'X'. Correct and resubmit

STC*A7>145>85*[DATE]*U*[AMOUNT]******A7>569**Invalid Taxonomy Code. The taxonomy code for Billing Provider does not meet the required format. Taxonomy codes must be 10 alphanumeric characters ending with 'X'. Correct and resubmit

STC*A7>145>85*[DATE]*U*[AMOUNT]******A7>569**Invalid Taxonomy Code. The taxonomy code for Billing Provider does not meet the required format. Taxonomy codes must be 10 alphanumeric characters ending with 'X'. Correct and resubmit