An adjustment is reported by populating Loop-ID 2300, Segment CLM, CLM05-3 with a Claim Frequency Type of 7.  Send 8 for a void.  All other values in the claim should contain the same values as the original claim, other than the values that are being adjusted.  You must also include the claim’s Transaction Control Number (TCN) as assigned by the eMedNY system during adjudication and reported to you in the electronic X12 835 (in CPL07) or paper remittance.  This is sent in Loop-ID 2300, REF segment (REF01 = F8) of the 837.  When adjusting a fee-for-service claim using the 837 Professional or 837 Dental it is essential that all the original service lines are still present in the adjustment.

Only previously paid claims should be adjusted or voided.  Claims that were denied due to billing error should be corrected and rebilled as original claims.

A claim can be voided/adjusted as long as it is less than 6 years old, based on the Date of Service.  However, claims over 2 years old are not paid by NYSDOH.  So if a 2-year old claim is voided, it cannot be re-billed.  Therefore in order to correct the information in a 2-year old or older claim, it should be adjusted instead of voided and re-billed.