Where on the HCFA / CMS 1500 do you put resubmission codes?

Where on the HCFA / CMS 1500 do you put resubmission codes?

Box 22 is where resubmission codes are entered on the CMS-1500 form. This box is also where the Original Reference Number of the previously submitted claim is entered. 

Elaboration:

  • Box 22: Resubmission Code/Original Ref. No.

This field is specifically designed to indicate whether a claim is a resubmission, correction, or replacement of a prior claim and to include the original claim number. 

  • Resubmission Codes:

When resubmitting a claim, enter the appropriate code on the left-hand side of Box 22. Common codes include: 

6: Corrected Claim 

7: Replacement of Prior Claim 

8: Void/Cancel of Prior Claim 

  • Original Reference Number:

Box 22 should also include the original claim number assigned by the insurance payer. This helps the payer identify the original claim and properly process the resubmission or correction. 

 

Below is an example of a resubmission code for a corrected claim, along with the original claim number assigned by the insurance payer