Reason Code 31337

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 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

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Last Updated Oct 19, 2018