CARC 306 Active

PR-306: Type of Bill Inconsistent with Patient Status

TL;DR

Uncommon combination. This is usually a provider billing error that should be corrected and resubmitted.

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-306 Mean?

PR with CARC 306 is uncommon since this is typically a provider billing error, not a patient responsibility issue.

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.

How to Resolve

  1. Review the claim for billing errors that caused the denial
  2. Correct the type of bill and patient status inconsistency
  3. Resubmit the corrected claim to remove patient responsibility
Do Not Appeal This Code

Type of Bill Inconsistent with Patient Status points to a coding or claim-information issue — typically resolvable by correcting the claim and resubmitting rather than appealing. Identify the specific coding or data problem (review accompanying RARC codes for detail), then submit a corrected claim. Appeals are only the right action if the original coding was correct and the payer applied the edit in error.

How to Prevent PR-306

Also Filed As

The same CARC 306 may appear with different Group Codes:

CO-306 OA-306

Related Denial Codes

PR-4 — Procedure Code Inconsistent with Modifier PR-5 — Procedure Code Inconsistent with Place of Service PR-6 — Procedure/Revenue Code Inconsistent with Patient Age PR-7 — Procedure/Revenue Code Inconsistent with Patient Gender PR-8 — Procedure Code Inconsistent with Provider Type/Specialty

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.