EOB denial code CO-198: what it means

What it means

Care was authorized, but the services billed went beyond what the authorization allowed.

Contractual Obligation — an adjustment the provider agreed to by contract. The patient is generally not billed for CO amounts.

Official X12 description

“Precertification/notification/authorization/pre-treatment exceeded”

Typical cause

More visits, units, or days were provided than the prior authorization covered.

What to do next

1. 1Compare what was authorized with what was billed.
2. 2If additional care was medically necessary, your provider can request an extension and appeal.