Box 22 - Resubmission Code/Original Ref. Number

Box Definition

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

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.
   
5. Select Edit.
6. Enter or edit the Internal Control Number.
7. Select Save.

EDI Loop/Segment

Loop 2300, Segments CLM05-3 and REF02