Reason Code 31102
- Value code dollar amount equal greater than $0.00
- Occurrence code 24 and date insurance denied not present
- Any required condition codes or occurrence codes not present based on Medicare Secondary Payer (MSP) value code
- Two-digit MSP explanation codes and date if required not present
- If billing value codes 15 or 47 and the benefits are exhausted, please contact the Benefits Coordination & Recovery Center (BCRC) to update the records and bill primary
- Value codes 16, 41 and 42 should not be billed conditional. You should bill Medicare primary.
- Value code 13 and value codes 12 or 43 cannot be billed on the same claim
- Insurance name and address do not match what is on the MSP Record at CWF. Contact the BCRC to update the records.
- Patient relationship code being billed doesn't match MSP record on CWF. Contact the BCRC and have records updated.
Please make corrections and resubmit your claim.
For assistance on how and when to bill Medicare secondary, refer to the following resources:
- CMS Medicare Claims Processing Manual (Pub. 100-04), chapter 25, section 75 (PDF, 238 KB)
- MLN Matters Article SE1217 (PDF, 105 KB)
- MLN Matters Article MM7355 (PDF, 815 K)