NM providers: Avoid denials for incorrect taxonomy

Beginning later this year, we'll deny claims with incorrect or missing taxonomy codes. This requirement follows New Mexico Health Care Authority (HCA) fee-for-service billing practices for Turquoise Care managed care organizations.

Common errors that delay or prevent payment

Error	What it means	What you should do
Missing taxonomy code	The claim doesn’t include the relevant taxonomy code for the services provided.	Add the correct taxonomy code before submitting the claim.
Incorrect taxonomy code	The taxonomy code does not match the provider classification, specialty or HCA registration.	Confirm the enrolled taxonomy and use the code assigned to the provider type.
Incorrect ZIP code	The ZIP code does not match the physical location where services were provided. Box 33 on the HCFA claim form Box 1 on the UB-04 claim form	Use the service location ZIP code associated with the site of care. Box 33 on the HCFA claim form Box 1 on the UB-04 claim form

Error

What it means

What you should do

Missing taxonomy code

The claim doesn’t include the relevant taxonomy code for the services provided.

Add the correct taxonomy code before submitting the claim.

Incorrect taxonomy code

The taxonomy code does not match the provider classification, specialty or HCA registration.

Confirm the enrolled taxonomy and use the code assigned to the provider type.

Incorrect ZIP code

The ZIP code does not match the physical location where services were provided.

Box 33 on the HCFA claim form
Box 1 on the UB-04 claim form

Use the service location ZIP code associated with the site of care.

Box 33 on the HCFA claim form
Box 1 on the UB-04 claim form

What you need to do

You must adjust your billing practices before this requirement goes into effect to submit claims with complete and accurate information — including taxonomy, provider type and billing data.

Enrollment categories can be verified in the New Mexico Medicaid Portal.