CARC 246 Active

PR-246: Non-Payable Code for Required Reporting Only

TL;DR

This code was submitted for tracking or reporting purposes only and was never intended to generate a separate payment. No action is needed unless the code was submitted in error.

Action
Review & Decide
Who Pays
Patient
Appeal
No
Patient Impact
Direct Financial
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 PR-246 Mean?

CARC 246 indicates that the line item on your claim was submitted using a non-payable code designated exclusively for required reporting purposes. This is not a denial of a service you expected to be paid — it is a confirmation that the code was processed exactly as intended: for data collection, not reimbursement.

These reporting-only codes appear in several contexts. In managed care or capitated arrangements, encounter data is reported for tracking purposes even though payment is not made on a per-service basis. In quality measurement programs, certain codes are submitted to satisfy statistical tracking or regulatory reporting requirements. In bundled payment arrangements, individual service codes may be reported for transparency while the payment is made through a separate mechanism.

If you are seeing CARC 246 on a line item you expected to generate revenue, the issue is likely a misunderstanding of the code's purpose or a billing configuration error where a reporting-only code was used instead of a payable service code.

How to Resolve

Confirm the code was intended for reporting only. If a payable service was provided, rebill with the correct payable code.

  1. Confirm the code is reporting-only Review the procedure code on this line item and verify it is designated for reporting purposes only. Check the CPT/HCPCS code description and payer-specific guidelines.
  2. Verify billing configuration If the line was expected to generate payment, check whether the wrong code was used. Verify that your billing system is correctly configured to distinguish between reporting-only and payable codes.
  3. Rebill if needed If the service should have generated payment, identify the correct payable code and resubmit the claim with the appropriate billing code.
  4. No action for correct reporting codes If the code was correctly submitted for reporting purposes, no further action is needed. The CARC 246 adjustment is expected and correct.
Do Not Appeal This Code

This is a non-payable code submitted for required reporting purposes only. It was never intended to generate separate payment. No appeal is warranted.

Also Filed As

The same CARC 246 may appear with different Group Codes:

CO-246 OA-246

Related Denial Codes

PR-13 — Date of Death Precedes Date of Service PR-14 — Date of Birth Follows Date of Service PR-19 — Workers' Compensation Claim PR-20 — Liability Carrier Responsible PR-21 — No-Fault Carrier Responsible

Sources

  1. https://x12.org/codes/claim-adjustment-reason-codes
  2. https://portal.ct.gov/-/media/ohs/health-it-advisory-council/apcd-advisory-group/data-submission-guide-workgroup/meeting-materials/6-30-22/carc-codes_final.pdf
  3. https://www.aapc.com/resources/claim-adjustment-reason-codes
  4. Codes maintained by X12. Visit x12.org for official definitions.