Dental-Provider Specialty Taxonomy Codes
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||1223D0001X|
|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
• 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.