CurrentBlue Cross Blue Shield - OklahomaPolicy CPCP025

Corrected Claim Submissions

Governs submission, format, and rules for corrected (replacement/void/late charge) claims submitted to Blue Cross Blue Shield of Oklahoma by participating providers.

Policy Summary

PayerBlue Cross Blue Shield - Oklahoma

PolicyCorrected Claim Submissions

Policy CodePolicy CPCP025

Change TypeRevised (frequency code clarification)

Effective DateJul 1, 2024

Next Review DateN/A

Key ActionSubmit corrected claims using frequency code 7 to replace and 8 to void and include the original claim number/DCN (REF02 F8) for electronic submissions.

SourceLink

POLICY UPDATE CHANGES

Changes to Claim Frequency Codes effective 07/01/2024.

1.0policy version

2024-07-01policy effective date

2023-12-11committee approval

Multipleupdate history

Corrected Claim Coverage Criteria

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Corrected claims must be filed within timely filing deadlines and may not be submitted until the original claim has been processed and the provider notified of claim status.

Corrected claims should be minimal; providers are urged to submit claims once all charges are documented to reduce processing errors and duplicate filing.

When submitting a corrected claim, provide required information to support the changes and include all accurate line items from the original submission on the replacement claim along with any corrected line items to avoid unintended refund or overpayment requests.

Acceptable reasons (examples)

Replace previous/original claim with correction, addition, or removal of charges (e.g., update diagnosis code, procedure code, modifier, units billed).
Update billed charges that comply with applicable law (increases without adequate justification are not considered corrected claims and may prompt review).
Cancel the previous/original claim (void/cancel).
Correct date of service.
Correct provider identification number.

Medical records or other supporting documentation may be required to justify corrections to diagnosis codes, DRGs, procedure codes, medication units, modifiers, or other modifications; examples include medical records, copy of the original claim, or documentation that a procedure was repeated on the same day.

Submission format and required data elements: electronic replacement claims or paper claim forms are acceptable; include the original claim number or DCN on the corrected claim and the Corrected Claim Review Form when applicable.

Frequency code requirements: use frequency code 7 to replace the entire prior claim (submit the claim in its entirety, including all services and the original DCN) and use frequency code 8 to void/cancel the prior claim; electronic replacement claims with frequency code 7 or 8 must include the original claim number or DCN in Loop 2300 REF02 with qualifier F8 (REF01).

Prohibition and consequences: do not submit corrected claims using frequency code 5 for late charges; corrected claims submitted with frequency code 5 or submitted without the appropriate frequency code will be denied or rejected and the original claim number/DCN will not be adjusted.

Late charges (additional charges submitted after the original bill) must be submitted as a corrected replacement claim (frequency code 7 for inpatient/outpatient resubmissions including original values and late/additional charges); failing to resubmit the entire claim may result in denial and potential recoupment or overpayment actions following any claim review.

Paper form guidance: professional providers should use CMS-1500 (08/05) and institutional providers should use UB-04 when submitting on paper; always include the original claim number/DCN and the appropriate frequency code (7 or 8).

Claim Frequency Codes and Electronic Submission

Claim Frequency Codesmixed

Frequency Code 7	Replacement of Prior Claim — file entire claim including all services; used to replace prior claim.
Frequency Code 8	Void/Cancel of Prior Claim — use to entirely eliminate previously submitted claim.
Frequency Code 5	Late Charges — not to be used for adding late charges; using may result in denial.

Electronic submission requirement for replacement/void

Electronic identifier requiredReplacement/void electronic claims must include the original claim number or Document Control Number (DCN) in Loop 2300 REF02 with qualifier F8 (REF01).

Allowed frequency codesUse frequency code 7 to replace a prior claim or frequency code 8 to void/cancel a prior claim for electronic replacement/void submissions.

Submission consequenceFailure to include the original claim number or DCN will generate a compliance error and the claim will be rejected.

Format referenceFollow ANSI X12 837 implementation (Loop 2300, REF02) when submitting corrected electronic claims.

Provider Submission Requirements and Risks

Billing Rule

Corrected Claim Submission Requirements

Submit corrected claims as an electronic replacement (frequency code 7) or on paper with all original claim data and the original claim number or Document Control Number (DCN). Include all line items that were previously processed correctly; reimbursement for line items removed from the corrected claim may be recouped. For paper submissions, Professional providers must use CMS-1500 (08/05) and Institutional providers must use UB04; include NPI (paper claims may be denied if only plan provider number is used).

Include the original claim number or DCN on all corrected claim submissions (electronic REF02 with qualifier F8 in REF01 for Loop 2300).
When submitting on paper, set CMS-1500 box 22 or UB04 box 4 to frequency code 7 (Replacement) or 8 (Void) and include required identifying data.
Attach the Corrected Claim Review Form (available on the provider tab of the plan website) when submitting paper corrected claims.

Denial Risk

Frequency Code and Late Charge Requirements / Denial Risk

Do not submit corrected claims for late charges using frequency code 5. Late/additional charges must be submitted as a corrected claim that replaces the entire claim using frequency code 7. Submitting with an incorrect frequency code (including code 5) may cause denial, rejection, or failure to adjust the original claim number/DCN. If a claim review was performed, only corrected charges identified during the review may be resubmitted post‑review; providers may still be obligated to refund overpayments for charges not removed from the corrected claim.

Late charges = changes for items/services billed after the original claim; resubmit entire claim with original values plus late charges using frequency code 7.
Electronic replacement claims with frequency code 7 or 8 must include the original claim number/DCN in Loop 2300 REF02 (qualifier F8) or the submission will be rejected.
A corrected claim submitted without the appropriate frequency code will deny and the original claim will not be adjusted.

Key Definitions

Definition of Corrected Claim

DefinitionA corrected claim is used to update a previously processed claim with new or additional information and is member- and claim-specific.

When to submitSubmit only if the original claim information was incomplete or inaccurate.

Submission methodsAll changes must be submitted via electronic or paper submissions; do not make corrections by calling the Plan.

Not an appealA corrected claim does not constitute an appeal.

Definition of Late Charges

DefinitionLate charges are additional charges for items and services submitted after the bill was created and not included on the original bill.

Submission requirementAll late charges must be submitted as a corrected claim (replacement) after the original claim has been processed.

Frequency code ruleResubmit the entire claim (original values plus late/additional charges) using frequency code 7 (Replacement of Prior Claim); do not use frequency code 5.

Denial riskSubmitting late charges using frequency code 5 may result in denial of the claim.