Reason Code 31997 - JE Part A

Reason Code Narrative

THE TOB IS EQUAL TO INPATIENT (11X, 18X, 21X, OR 41X), THE NON-COVERED CHARGES ARE GREATER THAN ZERO AND ARE EQUAL TO THE TOTAL CHARGES, AND OCCURRENCE SPAN CODE 79 OR M1 IS PRESENT ON THE CLAIM.

Common Reason Code Errors

• Entire claim is billed with non-covered charges with span code 79 or M1.

Common Reason Code Corrections

• This is a valid processing reason code. It does not reflect incorrect billing.

Resource

• CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 3

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