Understanding Box 22 Resubmission Codes on CMS 1500 Claims


Understanding Box 22 Resubmission Codes on CMS 1500 Claims


Box 22 and It's Resubmission Codes on CMS 1500 Form pertain in the following scenarios, Medical billing services include a code and a fieldwhich deals with submitting claims to insurance with details about the same.In this Comprehensive guide, I’ll cover and focus on Box 22. And especially its Roting the number with the selective Resubmission codes, as they indicate the unique reference number of a corrected or resubmitted claim.I’ll cover necessities for this module, including thoseWhich include Resubmission codes, their Ususages, ICN Number Medical billing Dos And Donts, Complete guide on coding and refiling New and corrected claims,it’s importance in this situation, and more. So get ready.

find more 👉👉 Mastering Box 22 and Original Reference Number-CMS 1500 

What is Box 22 on the CMS 1500 Form?


CMS 1500 form: Health Insurance claim form for reimbursement of services filed by a provider to claiming agent. Originating or primary processing office. Note that Box 22 of the CMS 1500 claim form is specifically designated as the place to enter the original reference number in reference to originally- filed and to resubmitted, refiled, or corrected claims. 

Corrected Claims via Box 22


Understanding Resubmission Codes


Resubmission codes inform us what type of claim is being submitted. The resubmission codes are as follows: XI ROAD ACCIDENT XX COVERED BY WORKERS’ COMP XXX WORKSITE ACCIDENT


Resubmission Code 6 - Corrected Claim


A corrected claim:Resubmission Code 6: Corrected claimThe corrected claim can be submitted only when there is an error or missing information in the previous submission.For example, a regular submission might state:‘This citation failed to include the names of authors of the paper ‘Natural theology and the physico-theological proofs of God’s existence’, published in the ‘Quarterly Review’.’The corrected claim within a resubmission needs to provide the missing information:‘This citation failed to include the names of authors of the paper ‘Natural theology and the physico-theological proofs of God’s existence’, published in the ‘Quarterly Review, vol VII, pp196-227 (1824)’.

Resubmission Code 7 - Replacement of Prior Claim


Resubmission Code 7 is used when a claim is being submitted to replace a previously submitted claim. These may be used when there is a coding change such as a change in diagnosis, procedure, or other information. [1]

👇👇learn more about Resubmission Code 7👇👇

Navigating Resubmission Code 7: A Comprehensive Guide


Resubmission Code 8 - Void/Cancel Prior Claim


Resubmission Code 8 refers to a claim that was voided or cancelled for any reason. It is used to indicate that a claim on a line should not be considered valid or processed because an error or inaccuracy was discovered after submitting a claim.

 [1]


The Importance of the Original Reference Number (ICN)


The Original Reference Number is the unique number given to a claim or encounter form in the destination paying system; also known as Claim Reference Number, it refers to a prior submitted claim or encounter when submitting a re-submission or correction claim, but cannot be used in the original claims submission. The Original Reference Number is what keeps the claims on track from back and forth between systems, allowing claims management and processing to run smoothly. [1]


Locating the ICN Number on a Claim


The ICN is contained in Loop 2300, Segment REF02 of the EDI file in the event that REF01 = F8 [1]

Frequently Asked Questions (FAQs)


FAQ 1: What is the purpose of Box 22 on the CMS 1500 form?

Answer: Refer to Box 22for previously referenced claim number when a claim is withdrawn to make correction; streamlines processing of such claims [1]


FAQ 2: How do I determine the appropriate resubmission code for my claim?

Answer: Resubmission Code 6: Corrected Claims Resubmission Code 7: Replacement of Prior Claims Resubmission Code 8: Voided or Cancelled Prior Claims


FAQ 3: Where can I find the ICN number on a claim?

C secretes less; people don’t want to be involved; animals don’t live so long; etc. Can you decode my answer, which is coded as ‘mathcal(Y)’: The ICN number is in Level 2300, Module REF02, of the EDI file, in particular where REF01=’F8’. 1.


 Conclusion


Box 22 resubmission codes often get glossed under, because many feel that if the form makes no sense, it will all come out in the wash. Outstanding claims are accurate claims matched to correct resubmission values indicating success for the claims process. Attention to each of these CMS 1500 codes is important because these codes carry weight. Numbers 6 and 7, corrected claim and replacement of prior claims, respectively, initiate the enrollee process anew, including creating a new claim number. And you can’t complete the first part of the objective without knowing how the other piece works to support this goal. Number 8, void or cancel of prior claim, stops the process, erases or nullifies the prior claim. The ICN number carries through this January 2023 CMS 1500 form and serves as the heart of the continuity in the claims process in February 2023. As you can see, the ICN number is critical to the continuity of the claims process. Taking the time and focusing on how each of these codes works and addresses the claim issue while you are training helps to contribute to successful billing practices. Always check official guidelines and billing codes for details about your individual situation.


References:

[1] Box 22 Resubmission Code/Original Ref. No. – Therabill. Retrieved from





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