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Correct your Professional (837) Claims Electronically

Corrected Professional 837 claims should be submitted electronically using one of the Frequency Type Codes in the 2300 CLM05:3 element that are listed below. Submitting corrected claims electronically improves turn-around time and relieves you of the need to file paper. Remember - electronically corrected 837 Professional claims do not need to be submitted on paper.

Value Code Title Definition
5 Late Charges Only This code is to be used for submitting charges to the payer that were received by the provider after the Admit Through Discharge for the Last Interim Claim has been submitted. However, providers should not use this code in lieu of an Adjustment Claim or a Replacement Claim.
7 Replacement of Prior Claim

This code is to be used when a specific bill has been issued for a specific Provider, Patient, Payer, Insured and "Statement Covers Period" and it needs to be restated in its entirety, except for the same identify information. In using this code the payer is to operate on the principle that the original bill is null and void, and that the information present on this bill represents a complete replacement of the previously issued bill.

However, providers should not use this code in lieu of a Late Charge(s) Only Claim.

8 Void/Cancel of Prior Claim This code reflects the elimination in its entirety of a previously submitted bill for a specific Provider, Patient, Payer, Insured and "statement Covers Period" dates. The provider may wish to follow a Void Bill with a bill containing the correct information when a Payer is unable to process a Replacement to a Prior Claim. The appropriate Frequency Code must be used when submitting the new bill.