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Back  RFI # 2173: Loop 2300, REF01=F8 Control#

Formal vs. Informal Help Informal Formal


Joyce Petrucci


In reviewing RFI 1278 (version 5010), it is clear that this REF Payer Claim Control number can be sent with frequency codes 7 and 8. There is a new frequency code Q - claims submitted for reconsideration/reopening outside of timely limits (effective 1/1/2016)

Would frequency code Q, be consider valid for using the Loop 2300, REF01=F8?

Submitter Assigned Keywords

Payer Claim Control Number


The 837I 005010X223A2, 2300 REF Payer Claim Control Number situational rule states 'Required when CLM05-3 (Claim Frequency Code) indicates this claim is a replacement or void to a previously adjudicated claim'. The rule does not specify which Claim Frequency Code values are considered to be “replacement” or “void” to a previously adjudicated claim.


Frequency Code Q is used for reopening/reconsidering a final determination or decision on a previously adjudicated claim that is outside of a payer's timely filing limits. When a provider submits a 'reopening/reconsideration' within the timely filing period, the provider would send a replacement claim (code value 7). A re-opening that is outside the timely filing limits might be considered a “replacement” claim and in those instances reporting the Loop 2300, REF01=F8 would be appropriate.
Submission 9/26/2016
Status Date 1/19/2017
Status F - Final
Primary References
Document X223.pdf
SectionLoop 230