Quick Tips: How to Correct or Void a ClaimNov 13, 2022
Have you ever submitted a claim with the incorrect CPT code? How about the Place of Service? Modifier? We all have!
This issue happens quite often in the insurance billing world and is a fairly easy fix!
Here's how to do it:
- Wait for the original claim to process and get the claim # (you can use Availity, the paper EOB, or whatever portal you use to see the ERA);
- On the already submitted claim form (CMS1500) in box 22, enter 7 for a replacement claim (if you are fixing an error) or 8 for a voided claim (if you need to CANCEL the claim)
- In Simple Practice (click edit to resubmit) Box 22 says 'resubmission code' and then has the options Original (1) claim (what you usually select) Resubmission (7) and Cancellation (8)
- In Availity there is a drop-down that says 'Billing Frequency' in the Claim Information section and you would select 7 'Replacement of prior claim' or 8 'Void/Cancelation of prior claim'
- In the next box where it says "original ref no" enter the claim # from the original processed claim;
- Enter the rest of the claim as usual: client info, CPT codes, etc. If you are voiding your original claim, the claim should look exactly like the original claim (except box 22).
- If there is a difference in pay due to a change in CPT code or voided claim, you should get a recoupment letter fairly quickly from the insurance company.
Box 22 in Simple Practice:
Box 22 In Availity:
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