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January 13, 2025

North Carolina Medicaid: Avoid rejected claims. Include billing taxonomy code and registered NPI.

This is a reminder that you must include the billing taxonomy code and registered National Provider Identifier (NPI) on claims for UnitedHealthcare Community Plan members. Previously, we denied claims without the taxonomy code. As of Jan. 9, 2025, we will reject the claim if the fields are incomplete.

 

The taxonomy field appears as optional on the online form, but North Carolina Medicaid requires it when the health care provider bills for a service. The following is a breakdown of when a taxonomy code is required:

  • Billing taxonomy and the health care provider’s registered National Provider Identifier (NPI) number are both required for professional and institutional claims. We will reject your claim if these fields are incomplete.
  • Rendering taxonomy only applies to professional claims. It’s only required if a rendering NPI is submitted on the claim to identify the health care professional who performed the service.
  • Attending taxonomy only applies to institutional claims. It’s only required if an attending NPI is submitted on the claim to identify the health care professional responsible for the overall care of the member.

 

To learn more about claim submissions and requirements, please review the North Carolina Claim Submission Interactive Guide

Questions? We're here to help.

Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal. For additional contact information, visit our Contact us page.

PCA-1-24-03696-UHN-NN_01132025

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