On the CMS-1500 claim form, Box 22 is only used when the claim relates to one you have already filed: the resubmission code tells the payer how to treat the new filing, and the original reference number identifies the earlier claim it corrects or voids. This guide explains what the box means and where Pabau takes the values from.
NOTE: This article is part of the US Insurance Billing Additional Resources series, which walks through every box of the CMS-1500. If you are new to claims in Pabau, start with Creating a US Professional (CMS 1500) Claim.
Box 22 — Resubmission code and original reference number
Box 22 has two cells. The resubmission code is a claim frequency code: 7 asks the payer to replace a previously filed claim with this corrected one, and 8 asks the payer to void (cancel) it. The Original Ref. No. cell carries the claim control number the payer assigned when it processed the original claim — often called the payer's ICN — which you will find on the payer's EOB, ERA, or denial. On a first-time claim both cells stay empty: an empty Box 22 means an original submission. Payers set their own resubmission rules, so check the original claim's denial or the payer's guidance for how they want corrections filed.
How Pabau fills it
Both values live in the Claim details section of the claim — the section labeled with CMS-1500 boxes 10, 22, 23, and 27. Resubmission code (box 22) offers 7 (corrected claim) and 8 (void), and Original reference no. (payer ICN) takes the number from the payer's EOB or denial.
On a new claim you leave both fields alone — Pabau prints and sends nothing in Box 22, and the claim goes out as an original submission. When a payer rejects or denies a claim, correct the claim, set the resubmission code to 7 (or 8 to void the original), enter the payer's ICN in the original reference field, and validate and send it again. On printed claims the same values appear in Box 22, because the print renders from the same validated claim data as the electronic file.
On the electronic claim: the resubmission code and the payer's ICN travel with the corrected claim, and because Pabau reuses the same claim identity, Claim.MD updates the original claim instead of creating a duplicate.
TIP: The original reference number is the payer's own control number, not a Pabau number. Take it from the EOB, ERA, or denial the payer returned for the original claim — the claim's response history is covered in Tracking Electronic Claim Submissions.
To follow a resubmitted claim through validation, submission, and the payer's responses, see Tracking Electronic Claim Submissions.