Corrected billing

You should submit corrected claims only when information has changed on the claim. For example:

• Errors were found involving diagnosis, procedure, date, or modifier.
• Claims contained missing, incorrect, or incomplete data according to our claim submission criteria.
• Services were missed in original submission.
• Post-adjudication audits detected incorrect DRG (diagnosis-related group) or other billing errors.

Rebilling

If there are no changes to a claim, do not rebill until you have confirmed that we have not received your claim. For more information, see Checking claims status.

Correcting electronic claims

You can submit corrected professional and institutional claims electronically by entering the original claim number in the notes and indicating Frequency code 7 as follows:

• Professional claims CMS-1500: Enter Frequency code 7 in Loop 2300 Segment CLM05-3.
• Institutional claims UB-04: Submit with the last character of the Type of Bill as 7, to indicate Frequency code 7.

Correcting paper claims

You can correct professional and institutional paper claims as follows:

• Professional claims CMS-1500: Stamp "Corrected Billing" on the CMS 1500 form.
• Institutional claims UB-04: Submit with the third digit of Type of Bill as 7 to indicate Frequency code 7.

Voiding previously adjudicated claim via EDI

You can request a void, or full reversal, of a previously paid claim by submitting an identical claim, entering the original claim number in the notes, and indicating Frequency code 8 as follows:

• Professional claims CMS-1500: Enter Frequency Code 8 in Loop 2300 Segment CLM05-3.
• Institutional claims UB-04: Submit with the last character of the Type of Bill as 8, to indicate Frequency code 8.