CARC 306 Active

OA-306: Type of Bill Inconsistent with Patient Status

TL;DR

The payer's edits caught the data inconsistency. Correct and resubmit.

Action
Resubmit
Who Pays
Depends
Appeal
Yes
Patient Impact
Indirect
Disclaimer
This content is for informational purposes only and does not constitute professional billing advice. Always verify information against your payer contracts and current coding guidelines. Consult a certified billing specialist for specific claim issues.

What Does OA-306 Mean?

The payer's automated edits or a secondary payer detected the TOB/patient status inconsistency during processing. The claim needs correction.

CARC 306 is triggered when the payer's automated edits detect a conflict between the type of bill (TOB) code and the patient status code on a UB-04 institutional claim. These two fields must be logically consistent — for example, an inpatient type of bill should correspond to an inpatient patient status, and a discharge status indicating transfer should be supported by the appropriate TOB frequency code.

Common mismatches include billing inpatient services when the patient was actually in observation or outpatient status, using a replacement claim frequency code on an original submission, or submitting a transfer TOB without a corresponding transfer discharge status. This denial requires the provider to review and correct the claim data before resubmitting.

Common Causes

Cause Frequency
Payer system edit rejection Payer's automated edits detected the TOB/patient status mismatch during adjudication Most Common
COB processing identified inconsistency Secondary payer detected the TOB/patient status mismatch when processing after the primary payer Common

How to Resolve

  1. Review the claim for TOB/patient status inconsistencies
  2. Correct the claim data and resubmit
  3. If the claim was correct, contact the payer to clarify the edit logic
Appeal Guide

Appeal with documentation showing the claim data was correct, including the UB-04 form and supporting medical records.

Common RARC Pairings

The RARC code tells you exactly what triggered the OA-306:

RARC Description
MA130 Your claim contains incomplete and/or invalid information. Review and correct the claim data inconsistency →

How to Prevent OA-306

Also Filed As

The same CARC 306 may appear with different Group Codes:

CO-306 PR-306

Related Denial Codes

OA-16 — Missing Information or Billing Error OA-4 — Procedure Code Inconsistent with Modifier OA-5 — Procedure Code Inconsistent with Place of Service OA-6 — Procedure/Revenue Code Inconsistent with Patient Age OA-7 — Procedure/Revenue Code Inconsistent with Patient Gender

Sources

  1. https://x12.org/codes/claim-adjustment-reason-codes
  2. https://www.cms.gov/medicare/payment/prospective-payment-systems
  3. https://med.noridianmedicare.com/web/jeb/topics/claim-submission/denial-resolution
  4. Codes maintained by X12. Visit x12.org for official definitions.