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Just thought I would share what took me 16 hours to find in case someone has the issue in the future.
A customer traveling through on I-40 with a fifth wheel rv in tow got a check engine light and stopped by the shop for us to have a look. Truck has 212,000 miles. Hooked up Snap-on diagnostic. Found a stored P0341 fault. Cleared fault and started engine and watched live data on the Snap-on. Cam speed readings were all over the place. Swapped places with CKP and CMP sensors and still had erratic cam speed readings. Pulled entire engine sensor harness off of engine to give a thorough inspection. Found 2 wires on CMP sensor plug in bad shape so I replaced all 3 wires on the CMP sensor plug. I also found a broken wire on the wastegate solenoid so I replaced both wires on the wastegate solenoid even though ECM didn't have a fault to indicate an issue. I reinstalled the sensor harness and fired the engine up. Still had erratic cam speed readings. Replaced CMP and CKP sensors with new genuine Cummins. Still getting erratic cam speed readings. Replaced MAP and rail pressure sensors with new genuine Cummins since they share the same 5 volt and ground with the CMP sensor. Still erratic readings on cam speed. Finally decided to pull the front cover on the engine. I found 1 complete bolt and 1 head of a bolt laying down in the bottom gear housing. The bolts belong to the cam thrust plate and being they not in place allowed the cam to walk. Luckily they some how didn't get caught up in the gear train on their way down. I managed to get the broken bolt out of the block with a pick then installed and torqued new bolts to 212 inch pounds. Reassembled front of engine and everything taken off to access front of engine. Fired engine up and now have steady cam speed readings that match crank speed. No more P0341 fault.
Owner was not sure if there was ever any major engine work done in the past since they have only owned it for about 6 months.