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.
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
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.
Found this code on your bill or EOB?
Upload the document — MD Bill Check decodes every code, checks the math line by line, and explains what's worth questioning.