Denial Code 198 (CO-198, PR-198) — Meaning & What to Do
Claim Adjustment Reason Code (CARC)
What denial code 198 means: Pre-authorization was over the approved limit or number of visits.
What to do about denial code 198: If you believe this is wrong, you can appeal with supporting notes from your doctor.
CO-198 vs PR-198 vs OA-198: what the prefix means
| Code on your EOB | What the prefix means | Who typically pays |
|---|---|---|
| CO-198 | Contractual obligation — the provider writes the amount off | Usually not the patient |
| PR-198 | Patient responsibility | The patient |
| OA-198 | Other adjustment | Often another payer or plan |
The prefix tells you who is expected to absorb the amount; the number (198) tells you why.
Seeing denial code 198 on your EOB?
A denial code tells you what the payer reported, but it may not tell the whole story. Reviewing your EOB and bill together can help clarify what may need attention.
Related codes
CARC 193The original claim was rejected or denied for a coverage reason.
CARC 199A revenue code and procedure code don't match.
CARC 192A non-standard adjustment was applied by the plan.
CARC 200Expenses were incurred during a lapse in coverage.
Keep reviewing your bill
- Medical Bill vs EOB: What Is the Difference?
- How to Dispute a Medical Bill — Find Billing Errors Before You Pay
- What Is an Itemized Medical Bill? How to Request One
Frequently asked questions about Denial code 198
What does denial code 198 mean on my EOB?
Pre-authorization was over the approved limit or number of visits.
What should I do about denial code 198?
If you believe this is wrong, you can appeal with supporting notes from your doctor.
Seeing this code on your own EOB?
Upload the EOB, the bill, or both — MD Bill Check reads the codes on your documents, compares them side by side, and flags what's worth questioning. Free, no account needed.