Claim Frequency Type Code 7 - Replacement Claim

August 26, 2026

Claim Frequency Type Code 7 identifies a replacement of a prior claim. It is commonly used when a payer has already adjudicated a claim and information reported on that claim needs to be corrected.

Rather than submitting another unrelated original claim, a replacement submission tells the payer that the new claim is associated with a previously processed claim and is intended to replace it.

Using Claim Frequency Type Code 7 correctly requires more than simply changing the frequency code. The payer must generally be able to identify the prior claim being replaced, and the replacement submission should contain the claim information the payer should use in place of the previous claim.

Claim Frequency Type Code 7: The Quick Answer

Claim Frequency Type Code 7 means Replacement of Prior Claim.

It is generally used when a previously adjudicated claim needs to be replaced with corrected claim information. The replacement claim commonly includes the payer's original claim reference or claim control number so the payer can identify the claim being replaced.

If the previous claim was rejected before adjudication, Code 7 is typically not appropriate. The rejection is generally corrected and the claim is resubmitted as an Original Claim (1), subject to payer-specific requirements.

What Does Claim Frequency Type Code 7 Mean?

Claim Frequency Type Code 7
Replacement of Prior Claim

A replacement claim is intended to replace a claim that the payer previously processed. The new submission contains the corrected claim information and identifies the prior claim to which the replacement applies.

This is different from simply submitting another original claim. Claim Frequency Type Code 7 communicates that the payer should associate the new submission with an existing claim and process it as a replacement.

When Should Claim Frequency Type Code 7 Be Used?

Code 7 is generally appropriate when a claim has already been adjudicated and information reported on that claim needs to be corrected.

Examples may include corrections to:

patient or subscriber information
provider information
diagnosis information
dates of service
procedure or service information
charges or units
other information reported incorrectly on the previously adjudicated claim

The specific correction procedures accepted by a payer can vary. Before submitting Code 7, verify that the payer requires a replacement claim for the type of correction being made.

The Claim Must Generally Have Been Adjudicated First

One of the most important considerations before using Claim Frequency Type Code 7 is determining what happened to the previous claim.

If the payer already adjudicated the claim and information on that claim needs to be changed, a replacement claim (7) may be appropriate.

If the previous submission was rejected before it successfully entered or completed adjudication, there may be no adjudicated claim to replace. The rejection is generally corrected and the claim is resubmitted as an original claim (1).

Previous Claim Status	What Needs to Happen?	Typical Claim Frequency Type
Rejected before adjudication	Correct the rejection error and resubmit the claim.	1 - Original
Previously adjudicated	Correct information reported on the processed claim.	7 - Replacement

Note: This is a general distinction. Always review the payer's current claim correction and resubmission requirements.

When Should You Not Use Claim Frequency Type Code 7?

Claim Frequency Type Code 7 should not automatically be used whenever a problem is discovered with a claim.

Rejected Claim

If the claim was rejected before adjudication, correct the rejection and typically resubmit it as an original claim.

Claim Should Be Canceled

If the intent is to cancel the prior claim rather than replace it, a Void/Cancel Claim Frequency Type Code 8 may be appropriate.

Adjudication Dispute

If the submitted claim information was correct but the provider disagrees with the payer's decision, reconsideration or appeal may be appropriate instead.

Claim Frequency Type Code 1 vs. Code 7

Claim Frequency Type Codes 1 and 7 communicate very different things to the payer.

Claim Type	Frequency Code	General Purpose
Original Claim	1	Initial claim submission or, generally, resubmission after correcting a claim that was rejected before adjudication.
Replacement Claim	7	Replaces a previously adjudicated claim with corrected claim information.

Do not simply send another original claim when the payer expects a replacement. If the prior claim has already been processed, another original submission may be treated as a duplicate rather than as a correction.

Claim Frequency Type Code 7 vs. Code 8

Codes 7 and 8 both reference a prior claim, but the intended result is different.

Claim Type	Frequency Code	Intent
Replacement	7	Replace the prior claim with the newly submitted claim information.
Void/Cancel	8	Cancel the prior claim rather than replace it with corrected claim information.

If the claim should continue to exist but needs corrected information, Code 7 may be appropriate. If the intent is to cancel the prior claim entirely, review whether the payer requires Code 8.

For a complete explanation of void claims, including when Code 8 should be used, what information is needed and common cancellation mistakes, see our Claim Frequency Type Code 8 - Void/Cancel of Prior Claim Explained guide.

What Information Is Needed With Claim Frequency Type Code 7?

Claim Frequency Type Code 7 tells the payer that the submission is a replacement, but the payer also needs to determine which prior claim is being replaced.

A replacement submission therefore commonly includes:

Claim Frequency Type Code 7 – identifies the submission as a replacement of a prior claim;
Payer Claim Control Number / Original Reference Number – identifies the prior claim in the payer's system; and
Complete corrected claim information – provides the information that should replace the prior claim.

Do not assume your patient account number or internal claim number is the payer claim control number. The payer claim control number is generally an identifier assigned to the prior claim by the payer.

Where Can You Find the Payer Claim Control Number?

The payer claim control number may be available on information returned by the payer after the original claim was processed. Depending on the payer and workflow, it may appear on an electronic remittance, explanation of payment, payer portal or another claim-status or payment record.

The exact name and location of this identifier can vary by payer. Before submitting the replacement, verify that the number being reported is the payer's identifier for the claim being replaced.

A Common Replacement Claim Mistake

Using the provider's own internal claim number in place of the payer's claim control number may prevent the payer from associating the replacement with the correct prior claim.

Claim Frequency Type Code 7 on the HCFA-1500 Form

For professional claims submitted on the HCFA-1500/CMS-1500 form, replacement claim information is reported in Box 22 - Resubmission Code and Original Reference Number.

Resubmission Code

Enter 7 to identify the claim as a replacement of a prior claim.

Original Reference Number

Report the payer's claim control or original reference number for the prior claim.

Learn More About Box 22

Our Box 22 guide explains the resubmission code, original reference number and corresponding electronic 837P claim information in greater detail.

HCFA-1500 Box 22 - Resubmission Code and Original Reference Number

Claim Frequency Type Code 7 on an Electronic 837P Claim

For an electronic professional claim, Claim Frequency Type Code 7 is reported as part of the claim information in the 837P transaction. The payer claim control number is also transmitted so the replacement can be associated with the prior claim.

At a high level, the electronic claim includes:

Claim Frequency Type Code 7 in the claim information; and
Payer Claim Control Number identifying the prior claim.

This article focuses on the billing use of Code 7 rather than the technical structure of the X12 transaction. For the specific 837P locations and a sample mapping, see our HCFA-1500 Box 22 guide.

Should You Submit the Entire Claim Again?

A replacement claim should generally be viewed as a complete replacement of the prior claim, rather than as a submission containing only the individual field or service line that changed.

For example, if a previously adjudicated claim contained several service lines and one line needs to be corrected, the replacement claim may need to include the complete claim with all applicable service lines, including the corrected information.

Think "Replacement," Not "Addition"

The replacement submission should represent the claim information that the payer should use in place of the prior claim. Do not assume that submitting only the changed information will cause the payer to merge it into the previous claim.

Payer requirements can vary, so review the payer's replacement-claim instructions before submitting the correction.

Replacement Claim Examples

The following examples illustrate common situations where determining the status of the prior claim helps identify the appropriate next step.

Example 1: Adjudicated Claim With Incorrect Information

A provider submits an original claim and the payer adjudicates it. The provider later discovers that information reported on the claim was incorrect.

Typical action: Review the payer's requirements for submitting a replacement claim (7) containing the corrected information and the payer's claim control number.

Example 2: Claim Rejected Before Adjudication

A claim is submitted, but a 277CA or other payer report indicates that required claim information is invalid. The claim does not successfully enter or complete adjudication.

Typical action: Correct the rejection and resubmit the claim as an original claim (1), rather than using Code 7.

Example 3: Previously Adjudicated Claim Should Not Have Been Submitted

The payer processed a claim, but the provider determines that the claim should be canceled rather than corrected and replaced.

Typical action: Review whether the payer requires a void/cancel claim (8) rather than a replacement claim.

Example 4: Provider Disagrees With the Payer's Decision

The payer adjudicates the claim using the information submitted. The provider believes the claim information was correct but disagrees with the payer's payment or denial decision.

Typical action: Review the payer's reconsideration or appeal procedures rather than automatically submitting a replacement claim.

Common Claim Frequency Type Code 7 Mistakes

Replacement claims can create additional processing problems when the relationship to the prior claim is not reported correctly.

Common Mistake	Why It Can Be a Problem
Using Code 7 for a claim that was rejected before adjudication	There may be no adjudicated claim for the payer to replace.
Submitting another original claim after the payer already adjudicated the claim	The new submission may be treated as a duplicate rather than as a correction.
Using the provider's internal claim number as the original reference number	The payer may be unable to identify the prior claim being replaced.
Reporting Code 7 without the payer's required original claim reference	The replacement may reject or fail to associate with the prior claim.
Submitting only the changed service or information	A replacement claim may be expected to represent the complete corrected claim.
Using a replacement claim when the real issue is disagreement with adjudication	The payer may require reconsideration or appeal instead of a claim correction.

Corrected Claim vs. Replacement Claim

The terms corrected claim and replacement claim are often used together. A corrected claim generally describes a claim containing changes to information on a previously adjudicated claim, while the replacement claim is the submission used to replace that prior claim.

Need a Deeper Explanation?

Our corrected vs. replacement claim guide explains why a rejected claim is typically resubmitted as original while an adjudicated claim requiring correction may need to be submitted as a replacement.

Corrected Claim vs. Replacement Claim: What's the Difference?

Frequently Asked Questions

Claim Frequency Type Code 7 means Replacement of Prior Claim. It identifies a claim being submitted to replace a prior claim.

Code 7 is generally used when a previously adjudicated claim contains information that needs to be corrected and the payer requires the corrected claim to replace the prior claim.

Not typically if the claim was rejected before it successfully entered or completed adjudication. The rejection is generally corrected and the claim is resubmitted as an original claim (1). Always follow payer-specific instructions.

A replacement claim generally needs the payer's original reference or claim control number so the payer can identify the prior claim being replaced. Exact requirements can vary by payer.

For applicable professional claims, Code 7 is reported in Box 22 - Resubmission Code. The payer's original reference or claim control number is also reported in Box 22.

A replacement claim is generally intended to replace the prior claim in its entirety and commonly includes the complete claim with the necessary corrections. Payer-specific requirements should always be reviewed before submission.

Code 7 identifies a replacement of a prior claim. Code 8 identifies a void or cancellation of a prior claim. A replacement provides corrected claim information, while a void is intended to cancel the prior claim.

Medical Claim Submission & Resubmission Articles

Explore additional Eclaims guides covering medical claim corrections, replacements, voids and resubmissions.

Explore the HCFA-1500 Form

Use our interactive HCFA-1500 form to explore individual claim fields and related professional billing guides.

View the Interactive HCFA-1500 Form

Important: Replacement claim requirements can vary by payer and program. The information in this guide provides a general overview and should be used together with the payer's current billing and claim submission requirements.

For technical requirements related to electronic professional claim submissions using the X12 837P transaction, refer to the official implementation guides published by X12.

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