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Last Modified: 10/5/2022 Location: FL, PR, USVI Business: Part A

Reject reason code 31997 FAQ

Q: We are receiving reject reason code 31997, what steps can we take to avoid this reason code?
Refer to the Part A reason code lookup for a description associated with the Medicare Part A reason code(s). Enter a valid reason code into the box and click the submit button.
A: You are receiving this reason code because your claim was submitted with non-covered charges with occurrence span codes (OSC) 79 or M1. These OSC indicate a period of non-covered care that is not medically necessary for which the provider is liable. Please review your claim for possible errors, correct and resubmit your claim if necessary.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.