Clinicians: Medicare Part B Crossover Claims Issue Tied to Error Code H31312

Since July 6, there has been a problem with 837 professional coordination of benefits/Medicare crossover claims in which Medicare is the secondary payer. The issue is specific to the Primary Payer 2320 AMT for claims that were submitted electronically with detail Primary Payer 2430 SVD amounts included. The system is not passing the primary payer’s paid amount correctly; therefore, affected claims are receiving error H31312 “The Payer Paid Amount does not equal the line level payment amounts less the adjustment amounts.” Once the system is fixed on August 4, CMS will begin to send repaired claims to your patients’ insurers that pay after Medicare. In the interim, physicians and practitioners should direct their vendors not to bill their patients’ supplemental insurers for balances remaining on Medicare Secondary Payer claims submitted between July 6 and August 3.


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