CMS 1500 FORM Field 22 - Resubmission and/or Original Reference Number

Field 22 - Resubmission and/or Original Reference Number


“Resubmission” means the code and original reference number assigned by the destination payer or receiver to indicate a previously submitted claim or encounter.

NUCC INSTRUCTIONSList the original reference number for resubmitted claims. Please refer to the most current instructions from the public or private payer regarding the use of this field.

When resubmitting a claim, enter the appropriate bill frequency code left justified in the left-hand side of the field.

7 Replacement of prior claim
8 Void/cancel of prior claim

This Item Number is not intended for use for original claim submissions.

MEDICARE INSTRUCTIONS - Leave blank. Not required by Medicare.