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Subspecialty Certification

Urogynecology and Reconstructive Pelvic Surgery Taxonomy Code

If you passed the Urogynecology and Reconstructive Pelvic Surgery Board Exam, Update your Medicare Enrollment and Private Insurance Contract Information to reflect this Specialization.

Healthcare Provider Taxonomy Codes are designed to categorize the type, classification, and/or specialization of health care providers. The Code Set is maintained by the National Uniform Claim Committee. The Code Set is a Health Insurance Portability and Accountability (HIPAA) standard code set. As such, it is the only code set that may be used in HIPAA standard transactions to report the type/classification/specialization of a health care provider when such reporting is required. Because this is a new code, it is possible every region in the country has not adapted the new code. It would be prudent to contact your Medicare Part B Contractor to ensure the new code is recognized prior to submitting any claims. The taxonomy code does change reimbursement.

Why is it important to update your Healthcare Provider Taxonomy Code?

As the Centers for Medicare and Medicaid Services (CMS) continues to implement the Value-Based Payment Modifier for physicians, physicians’ quality and cost, “scores,” will be compared to their peers. One way for the Medicare program to define peers is by using taxonomy codes or two-digit specialty codes. For the tiering provisions of the value-Based Payment Modifier, CMS is proposing to use two-digit specialty codes. But, over time that could change. For Medicare, the Internet-based Provider Enrollment, Chain and Ownership System (Internet-based PECOS) can be used to update your enrollment information. Please visit the page of the Centers for Medicare and Medicaid Services (CMS) website for the Internet-based PECOS system where there is a tutorial regarding how to use this system to update your Medicare provider and National Provider Identifier (NPI) information.

http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/InternetbasedPECOS.html

Urogynecology and Reconstructive Pelvic Surgery Taxonomy Code: 207VF0040X

Urogynecology and Reconstructive Pelvic Surgery​ Definition
A sub-specialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.

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