Reason Code 31406

Description
If an occurrence code 01,02, 03 or 04 is present on the claim, one of the following must also be on the claim:

  • Value codes 12, 13, 14, 15, 16, 41, 42, or 43
  • Condition code 08
  • Occurrence code 24

Resolution
The service was denied because the patient has primary insurance through their (or their spouse’s) employer. Please verify the information on the claim and submit a new claim, if appropriate. The new claim may be submitted via electronic media.

Resource
CMS Medicare Secondary Payer webpage. For assistance on how to submit MSP claims, select Your Billing Responsibilities.