OA-306: Type of Bill Inconsistent with Patient Status

What Does OA-306 Mean?

OA-306 appears less frequently and typically indicates the type of bill inconsistency involves a system or processing issue rather than a straightforward provider billing error. This may occur in coordination of benefits scenarios or when the payer's system has conflicting patient status information from a different source.

When CARC 306 appears on a remittance, the payer is flagging a mismatch between the type of bill (TOB) code on your UB-04 and the patient's admission or discharge status. The type of bill is a four-character code that tells the payer the facility type, the care setting (inpatient, outpatient, etc.), and the billing frequency. When this code conflicts with the patient status code — which indicates the patient's condition at discharge or at the end of the billing period — the payer cannot process the claim.

Common scenarios that trigger CARC 306 include submitting an inpatient type of bill (011x) for a patient who was in observation status, using an outpatient type of bill (013x) for a patient who was formally admitted as an inpatient, or having a discharge status code that contradicts the type of bill. The observation-versus-inpatient distinction is a particularly frequent source of this denial, especially when a patient's status changes during the encounter.

This is a correctable billing error. The payer has not made a coverage or medical necessity determination — they simply cannot process the claim because the data elements contradict each other. Once you identify which code is wrong (the type of bill or the patient status), correct it and resubmit.

How to Resolve

Identify whether the type of bill or patient status code is incorrect, correct the mismatched code, and resubmit the claim.

1. Review the payer's patient status records Contact the payer to understand what patient status information they have on file and where the conflict originates. It may differ from your records due to data from another facility or payer.
2. Correct and resubmit or provide supporting documentation If your codes are correct, provide the payer with medical record documentation supporting the type of bill and patient status. If their records are correct, update your claim accordingly.

Common RARC Pairings

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

How to Prevent OA-306

• In COB scenarios, verify patient status information with each payer in the billing sequence to ensure consistency across all claims

Also Filed As

The same CARC 306 may appear with different Group Codes:

Related Denial Codes