Reason Code 31337

You entered a value code 41, 42 or 43 (Black Lung, VA or LGHP) In field 46. However, you did not enter an appropriate source of payment indicator in field 71.

Please submit the claim with source of payment indicator as:

  • Value code 41 = H
  • Value code 42 = I
  • Value code 43 = G

CMS Internet Only Manual (IOM), Publication 100-5, Medicare Secondary Payer (MSP) Manual, chapter 3 (PDF, 234 KB).

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