PR-282: Procedure/Revenue Code Does Not Match Type of Bill

What Does PR-282 Mean?

When paired with Group Code PR, CARC 282 shifts the financial responsibility to the patient. The adjustment for procedure/revenue code does not match type of bill is deemed the patient's responsibility. The provider should verify the PR designation is correct before billing the patient.

CARC 282 indicates a technical billing error where the procedure or revenue code submitted on the claim is inconsistent with the type of bill (TOB). This is a structural mismatch — certain codes are only valid with specific bill types, and the payer's system flagged the inconsistency during claim processing.

Common examples include billing an outpatient procedure code on an inpatient bill type, using a revenue code that is not valid for the submitted bill type classification (inpatient, outpatient, SNF, home health, etc.), or selecting the wrong type of bill in the billing system altogether. These errors are typically data entry mistakes or billing system configuration issues rather than clinical documentation problems.

The 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF) often provides additional detail about which specific code triggered the inconsistency. This code is a straightforward billing correction — fix the mismatch and resubmit. Appeals are not appropriate because this is a correctable coding error.

How to Resolve

1. Verify patient responsibility Confirm that the PR group code assignment is correct for the CARC 282 adjustment. Review the remittance advice and any RARC codes for context.
2. Review for potential errors Check whether the underlying denial reason can be corrected, which may eliminate the patient's responsibility. Verify coding accuracy and documentation completeness.
3. Appeal if designation is incorrect If the PR assignment appears incorrect or the denial is in error, file an appeal with supporting documentation before billing the patient.
4. Generate patient statement If the determination is correct, generate a patient statement for the amount and follow standard patient collection procedures.
5. Communicate with the patient Explain the charge to the patient, provide information about their financial responsibility, and discuss payment options.

How to Prevent PR-282

• Verify patient coverage and financial responsibility before rendering services
• Communicate potential out-of-pocket costs to patients proactively
• Review PR-282 adjustments before billing to confirm the designation is appropriate

Also Filed As

The same CARC 282 may appear with different Group Codes:

Related Denial Codes