CO-198Contractual ObligationAuthorization
CO-198 Denial Code: Precertification/authorization exceeded
Precertification/notification/authorization/pre-treatment was exceeded (more units/visits than authorized).
Why CO-198 happens
- ●Visits or units beyond what the auth approved
- ●Auth not extended when treatment continued
How to fix a CO-198 denial
- 1
Compare billed units to the authorization
- 2
Request an extension/additional units retroactively if allowed
- 3
Appeal with clinical justification for the overage
How to prevent it
Track auth unit burn-down and request extensions before exhausting them.
Drowning in CO-198 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.