Reason Code 31256

TOB of 12x, 13x, 22x, 23x, 34x, 74x or 75x with revenue code 043x without an occurrence code 17 or claim billed with occurrence code 17 without revenue code 043x.

This claim contains Revenue Code 043x (occupational therapy) but there is no occurrence code 17 (date outpatient OT plan established or last reviewed).

There is an occurrence code 17 but no Revenue Code 043x on the claim. Add occurrence code 17 or Revenue Code 043x or remove them as necessary to correct claim. Please correct and resubmit.

CMS Internet Only Manual (IOM), Publication 100-4,
chapter 4 (PDF, 1.26 MB).

Contact Palmetto GBA JM Part A Medicare

Provider Contact Center: 855-696-0705

Email Part A

Contact a specific JM Part A department

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC


National Supplier Clearinghouse MAC


RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries



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