Reason Code 31023

Description
There is a non-payment code present and it is not equal to R, N or Z, the total covered charges are greater than zero, or there is no non-payment code present, total covered charges are equal to zero.

Resolution
The claim is being returned for one or more of the following reasons:    

1. Providers must check the charge page and type of bill. If billing for non-covered services, the third digit of the type of bill should be zero. If billing for covered services, the third of the type of bill must be 1 through 9.      
2. If billing for non-covered services providers must show reason for non-coverage: condition code 20/21, occurrence code or occurrence span code     
3. Medicare secondary claim has been submitted without covered charges and/or contains a condition code 20 or 21. Medicare secondary claims must contain covered charges and cannot be billed with condition code 20 or 21.          
4. Condition code 04 or 04/69 should not be billed as non-covered. Move charges to covered correct type of bill if need be and resubmit as covered.
5. If benefits are exhaust claim should be submitted as covered not non-covered. Please correct and resubmit.
6. If this claim should be covered, make corrections to the type of bill, move noncovered days to covered days, and correct noncovered charges to covered charges by deleting and reentering the revenue code lines as covered in the first blank line available. Please make correction and resubmit.

Resource
CMS Internet Only Manual (IOM), Publication 100-4, Medicare Claims Processing Manual.