NUCC Provider Taxonomy
The NUCC manages the content of the 1500 Health Claim Form.
The code system of interest for C-CDA is actually the “Health Care Provider Taxonomy” from the NUCC – National Uniform Claim Committee. They have more than one “set of codes”: Condition codes, Provider Characteristics, and the Provider Taxonomy. Because of this the code system should not be simply called “NUCC” but instead called NUCC Provider Taxonomy.
The “Condition Codes” are actually a subset of NUBC codes and so this is a value set using NUBS condition codes.
“Provider Characteristics”: “This code list is for use with health care provider information for enrollment and credentialing transactions and their corresponding responses. It is intended to provide codified responses to questions presented to a health care provider applying to or registering with an entity and to report the outcome of such application or registration. It may also be used for responses to inquiries regarding provider participation or registration in a program or plan.” Therefore this is actually another NUCC code system.
Provider Taxonomy:
The NUCC is managed by the AMA but the code system is freely available. http://www.nucc.org/index.php?option=com_content&view=article&id=14&Itemid=125
The Chair of the committee is Nancy Spector (AMA Director, Coding and HIT Advocacy). Her number is 312-464-4586; email . She is willing to be the contact for the code system.
Release site: http://www.nucc.org/index.php?option=com_content&view=article&id=107&Itemid=132
It is released January 1 and July 1 every year (twice a year.) CSV file format. This new version is identified using the published date may be used for content 3 months later – April 1 and Oct. 1. There is no notice system for updates, they just appear on the noted two dates. Modification and new codes are outlined on web pages, there is no update file.
Latest release 7/1/2015. The CSV can be downloaded from the web site: http://www.nucc.org/images/stories/CSV/nucc_taxonomy_151.csv
Nancy has confirmed that AMA is willing to have the Provider Taxonomy be included in the UMLS.
Structure
There are currently 838 codes with the structure noted in the table below. Review of the content indicates that the “Type” is a general grouper and apparently is not meant to be used without at least the “classification” characteristic also provided. In addition, when there are additional “Specialization” terms below a specific Classification, the code system provides a code for the “Classification” only. This means that while the “Type” string is to be included in the name and maybe useful for general grouping, “types” do not get their own codes and in fact function essentially as an attribute of the concept. As an attribute we can then potentially use them as search criteria when looking for specializations that occur in multiple codes.
In C-CDA 2.0 specification (replicated in the 2.1 specification) the lack of a clear print name for the codes resulted in the specification using a made-up print name based on a pattern that used what appears to be an EN-dash with a space on either side. While this could work, when the NUCC committee was contacted about the proper description for the codes, they noted that the description must include type, classification, and specialization. They provided examples that indicate that the name is to be a concatenation of “;“ between the Type and the Classification strings, and where necessary, a “,“ between the Classification and Specialization strings.
Codes are 10 digits and have no “logic.”
Examples:
Code / Type / Classification / Specialization / Print name103TW0100X / Behavioral Health & Social Service Providers / Psychologist / Women / Behavioral Health & Social Service Providers; Psychologist, Women
104100000X / Behavioral Health & Social Service Providers / Social Worker / Behavioral Health & Social Service Providers; Social Worker
1041C0700X / Behavioral Health & Social Service Providers / Social Worker / Clinical / Behavioral Health & Social Service Providers; Social Worker, Clinical
1041S0200X / Behavioral Health & Social Service Providers / Social Worker / School / Behavioral Health & Social Service Providers; Social Worker, School
106H00000X / Behavioral Health & Social Service Providers / Marriage & Family Therapist / Behavioral Health & Social Service Providers; Marriage & Family Therapist
111N00000X / Chiropractic Providers / Chiropractor / Chiropractic Providers; Chiropractor
111NI0013X / Chiropractic Providers / Chiropractor / Independent Medical Examiner / Chiropractic Providers; Chiropractor, Independent Medical Examiner
111NI0900X / Chiropractic Providers / Chiropractor / Internist / Chiropractic Providers; Chiropractor, Internist
385HR2055X / Respite Care Facility / Respite Care / Respite Care, Mental Illness, Child / Respite Care Facility; Respite Care, Respite Care, Mental Illness, Child
There is a place for a definition on each code but for many the definition is “to come…” There is also a note field that often has source information.
The web site lists new codes and modifications on separate web pages. These seem to only discuss the current release. It is unclear if code meaning permanence is maintained in the modification process.
OIDs
The code system is registered at HL7 with the name “Health Care Provider Taxonomy,” short name “providertaxonomy”, and OID 2.16.840.1.113883.6.101. This OID is used in all the MU-related specifications but the name seems to be somewhat variable. We should use the official name I’ve noted here.
The value set that references this seems to have the entire code system included and is named “Healthcare Provider Taxonomy (HIPAA)” with OID 2.16.840.1.114222.4.11.1066.
License info
Note that vendors must request a license to include this in a product: “Vendors interested in incorporating the Health Care Provider Taxonomy code set into their commercial products must complete the license request form found on the CSV page.” Using this form: http://www.nucc.org/index.php?option=com_content&view=article&id=111&Itemid=110 that just notes the license info below and asks for contact information.
Nancy has confirmed that for notice of licensure all that would be needed is the following sentence:
For information on the Health Care Provider Taxonomy code set licensing requirements, please see www.nucc.org.
AMA licensing contact number: 312-464-5022 (AMA IP services)
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