New Mexico: Correct taxonomy and ZIP codes required on claims

Updated taxonomy crosswalk available

Beginning in March, we will reject claims submitted without a taxonomy code and deny claims with incorrect taxonomy and/or ZIP codes. This rule follows the New Mexico Healthcare Authority (HCA) fee-for-service billing practices for all Turquoise Care managed care organizations.

Updated taxonomy codes

Turquoise Care recently updated its taxonomy crosswalk based on changes from the National Uniform Claim Committee (NUCC). Please sign in to the New Mexico Medicaid Portal to identify the appropriate taxonomy for provider enrollment and claim submission.

Help avoid claim denials

Use the appropriate billing taxonomy code assigned to your provider type when submitting claims. Taxonomy codes for institutional and professional claims must match the health care provider’s HCA registration. We’ve seen a high number of claims with the following errors:

• Missing taxonomy code – All claims must include the relevant taxonomy code for the services provided. Taxonomy codes ensure standardized identification across all payers. 
• Incorrect taxonomy code – The unique, 10-digit number designates the classification and specialization of the billing and rendering health care providers. 
• Incorrect ZIP code – Taxonomy and ZIP codes help determine adequate specialty coverage for a network within a specific area. Submit the ZIP code associated with the physical location where services were provided.