What CO-198 means
The services billed go beyond what was authorized, for example more visits or units.
The CO group code means this amount is a contractual obligation: under most contracts you cannot bill it to the patient.
Common causes
- Visits or units beyond the approved number
- Dates outside the authorized range
How to fix it
- Request an extension or new authorization
- Track authorized units against visits
Check the remark code (RARC) that came with the denial and the payer's own policy, since rules vary by payer and plan. This is a plain-English summary written by GetMax; the official code text is published by X12 at x12.org/codes.
Prevent it next time
Most denials are caused before the claim is sent. See 12 ways to reduce claim denials, or let our denial management team work them for you.