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CO-198 - Denial Journal
CARC CO — Contractual Obligation

CO-198

Precertification/notification/authorization/pre-treatment exceeded

What This Code Means

The service exceeded the scope, units, or date range of the authorization that was actually obtained.

Common Causes

  • More units/visits performed than the authorization allowed
  • Service performed after the authorization's approved date range expired

How to Resolve or Appeal

  1. Compare units/dates billed against the approved authorization exactly
  2. Request an authorization extension or additional units if clinically justified, and appeal with that documentation

Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.

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