Reason Code: 31197
Error Description:
The claim is bill type 13X or 85X and contains condition code 89 and a 9-digit ZIP Code; however, a one-to-one cannot be made to an OTP CCN.
Avoiding/Correcting This Error
Verify that all information is keyed correctly according to the applicable entry in the SAMHSA Opioid Treatment Program directory and your Medicare Part A enrollment information. When corrections are completed, return the claim for processing.
Related Content
- OTPs fully-certified by the SAMHSA and accredited by a SAMHSA-approved accrediting body can enroll in the Medicare Program to bill for covered services
- CMS website: Opioid Treatment Programs (OTP)
- Includes: General information; Enrollment; Billing & Payment
- CMS MLN OPIOID Treatment Programs (OTPs) Medicare Enrollment Fact Sheet