UB04 Condition Codes Code 31: Patient is Student (Full-Time Day)

Overview

Condition code 31 (Patient is Student (Full-Time Day)) is a UB-04 condition code defined by Noridian Healthcare Solutions for Medicare Part A claims. It indicates that the patient is enrolled as a full-time day student at an educational institution. The code appears in the list of condition codes maintained by Noridian, which serves as a standard reference for Medicare contractors. ^[1]
The specific meaning is “Patient is a student (full time day),” as shown in the extracted code-to-description mapping. [Source text: “31: Patient is a student (full time day).”]
This code is part of a four-code set addressing different student statuses: full-time day (31), cooperative/work study (32), full-time night (33), and part-time (34). Accurate use of code 31 helps payers understand the patient’s primary activity, which can affect coordination of benefits, especially when the patient has other insurance. ^[1]
Providers should apply this code only when the patient’s educational enrollment matches the “full-time day” description. The code is applicable across all care settings—inpatient, outpatient, and others—as long as the patient’s status is relevant to the claim.

When to Use

Condition code 31 should be used when the patient is a full-time day student. “Full-time day” means the student is enrolled in a course of study that meets the educational institution’s definition of full-time attendance and takes place primarily during daytime hours. This status is common for traditional college or university students but also applies to other educational programs (e.g., vocational training). The code is selected from a group of student condition codes (31–34) listed in the Noridian condition code set. ^[1]
Distinguishing among the student codes is critical: code 31 is not appropriate for a student in a cooperative or work-study program (use code 32), a full-time night student (use code 33), or a part-time student (use code 34). [Source text lines for codes 32, 33, 34]
Use of code 31 is not limited by age or care setting. For instance, a 19‑year‑old inpatient receiving treatment for an injury would require this code if they are a full-time day college student. Similarly, an outpatient clinic visit for a routine check‑up may also carry this code. The presence of the code alerts the payer to the patient’s student status, which may be relevant for secondary payer rules or coordination with other insurance (e.g., employer‑group health plans under the Medicare Secondary Payer provisions). However, the Noridian source does not detail specific payer impacts beyond the code meaning; therefore, providers should follow their individual payer’s guidelines for when to report this code. ^[1]

Step-by-Step Claim Example

A 21‑year‑old patient is admitted to an acute care hospital for an appendectomy. The patient is a full‑time day student at a local university. The biller prepares the UB‑04 claim. In the condition code fields (typically form locators 18–28), the biller enters code 31 to indicate the patient’s student status. The code appears in the claim as “31” in one of the available condition code slots. ^[1]
The biller also includes other required condition codes (e.g., if the patient has other insurance, code 03 or appropriate TPL codes). After completing the claim, the biller submits it to the primary payer. The payer’s processing system reads code 31 and recognizes that the patient is a full‑time day student. This information may be used to check whether the student has coverage through the educational institution or a parent’s employer group health plan that should be billed as secondary. ^[1]
The example demonstrates the straightforward inclusion of code 31 based solely on the patient’s verified full‑time day enrollment. No additional supporting documentation is required by the code definition itself, but providers should maintain records of the patient’s student status for audit purposes. The step-by-step process is: verify full-time day enrollment → select code 31 from the student codes → enter it in the appropriate condition code field(s) on the UB‑04. ^[1]

Common Mistakes & Audit Red Flags

A frequent mistake is using code 31 for a patient who is not a full‑time day student. For example, using it for a part‑time student (who should have code 34) or for a cooperative work‑study student (code 32) leads to inaccurate claim data. ^[1]
Another common error is omitting a student condition code entirely when the patient is a student. This omission may cause the payer to miss important secondary payer information, potentially resulting in claim denials or improper payments. Providers should systematically ask about patient status during registration.
Audit red flags include an age‑condition conflict: although code 31 has no age limit, a claim with this code for a patient over 30 may attract scrutiny if the provider cannot document active full‑time day enrollment. Similarly, using multiple student codes on the same claim (e.g., both 31 and 34) is incorrect and will be rejected. ^[1]
To avoid issues, always verify the patient’s educational status against the four student codes. Retain documentation such as a student ID, class schedule, or a signed attestation. Payers may request this evidence during audits. While the Noridian source does not specify documentation requirements, using the correct code from its list is the first step to compliant billing.

Related Codes/Fields

Code	Meaning	Source
31	Patient is a student (full time day)	[1]
32	Patient is a student (cooperative/work study program)	[1]
33	Patient is a student (full-time night)	[1]
34	Patient is student (part-time)	[1]

These four codes form the complete student status set within the Noridian condition code list. They should be used mutually exclusively—only one per patient per claim. Providers may also find that other condition codes (e.g., code 10 regarding employment) interact with student status when determining secondary payer responsibilities, but the Noridian source does not explicitly link them. The UB‑04 form accommodates multiple condition codes in fields 18–28, so a claim with code 31 may also include codes for other circumstances (e.g., code 03 for other insurance). Use the table above as a quick reference when selecting the correct student code.

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References

[1] Noridian Condition Codes — https://med.noridianmedicare.com/web/jea/topics/claim-submission/condition-codes