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US · guidance

CMS Pub. 100-04, ch. 27, § 20.3.2.3

Cancel/Void Claim Accepted

activein force · 2026-08-25 – presentas-observed

This action cancels or voids a previously processed claim posted to CWF History. All

utilization and deductibles associated with the claim are backed out. The MAC receives

a disposition code informing it that the cancel/void action was accepted.

• Disposition code 03

• Basic Reply Trailers

History

(Rev. 4009, Issued: 03-23-18, Effective: 04-23-18, Implementation: 04-23-18)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
0c2ca202bee6083a6ed118d8ab7eda7a34fc2b95af76a270e4ac3a80e594ebb1
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CMS Pub. 100-04, ch. 27, § 20.3.2.3 — Cancel/Void Cla… · binding.law