Understanding Healthcare Provider Taxonomy Codes (HPTC) & HIPAA Compliance

A Healthcare Provider Taxonomy Code, or HPTC, is a standard code mandated by the 1996 Health Insurance Portability and Accountability Act, or HIPAA. It is used by health care providers in situations in which a code is required to process and pay claims. Codes are divided into two categories: individuals, such as physicians; and non-individuals, such as health care organizations. The codes consist of 10 numerals, and are self-selected, which means that a doctor selects a code based on the one that most closely matches the service he provides. You can obtain a code by visiting the Washington Publishing Company's website.

Instructions

• 1

  Visit the WPC website at WPC-edi.com and click "Code lists."

• 2

  Click "Taxonomy code set" under the heading "Health care."

• 3

  Review the extensive list to find the category that matches the health care you provide. For example, if you are a pediatrician, locate "Pediatrics" and review the choices under this heading, which includes adolescent medicine, child abuse and pediatric cardiology. Each heading and subheading has a specific taxonomy code.

• 4

  Click "definition" to the right of the code, which generates a short description. Read the definition to make sure it fits the services you provide. Write down the code and put it in your files for future reference.