Reason Code 31337 - JE Part A

Reason Code Narrative

ONE OF THE FOLLOWING CONDITIONS HAS OCCURRED:

1. A VALUE CODE 41 IS PRESENT AND PAYER ID 1 IS NOT EQUAL TO H OR C.
2. A VALUE CODE 42 IS PRESENT AND PAYER ID 1 IS NOT EQUAL TO I OR C.
3. A VALUE CODE 43 IS PRESENT AND PAYER ID 1 IS NOT EQUAL TO G OR C.

Common Reason Code Errors

• A claim is billed as a Medicare Secondary Payer (MSP); however, more than one MSP value code is present.
• A claim contain both a Working Aged (12) value code and a Disabled (43) value code.
• A claim was submitted listing an insurance primary to Medicare; however, no value code is present for type of MSP or incorrect value code is present for type of insurance.

Common Reason Code Corrections

• Resubmit claim using the correct MSP value code for beneficiary's insurance.

Note: Beneficiaries' 65 years or older are eligible for Working Aged coverage. Beneficiaries' less than 65 years old are eligible for Disabled coverage.

Resource

• MSP Decision Tree - Who Pays First

View reason code list, return to Reason Code Guidance page.