Box 22 - Resubmission Code/Original Ref. Number

  • Updated

Box Definition

Box 22 on the CMS-1500 form is where the Resubmission code or Internal Control Number (ICN) is entered.

mceclip0.png

Here are some examples for Resubmission Codes:

  • 0 - Original Claim
  • 7 - Replacement of Prior Claim 
  • 8 - Void/Cancel Prior Claim 

In AveaOffice

To change the Resubmission Code, please see our article on Claim Corrections.

To change the Original Reference Number on the Claim Form:

  1. Navigate to the patient's treatment episode.
  2. Select Insurance > Claims.
  3. Select the Claim Number.
  4. Navigate to Work Claim > Workflow.
    Edit Claim Instance from Patient Treatment Episode.png
  5. Select Edit.Edit Workflow.png
  6. Enter or edit the Internal Control Number.Edit ICN.png
  7. Select Save.

 

EDI Loop/Segment

Loop 2300, Segments CLM05-3 and REF02 

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