Healthcare Error Code
Healthcare Insurance / Medical Billing
Common Medicaid / Commercial
CO-198 | Preauthorization missing
Industry
Healthcare
Canonical
/healthcare/error-codes/co-198/
Last Updated
Feb 25, 2026
Summary
This code indicates that required preauthorization was not obtained before services were provided.
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What This Code Means
CO-198 is applied when payer rules require preauthorization and none is on file. This reflects benefit management policies rather than service quality. Coverage eligibility depends on meeting authorization requirements. The code does not indicate improper care delivery.
Where Users Usually See This Code
- EOB statements
- Remittance advice
- Authorization review notices
Why This Code Appears
- Preauthorization not requested
- Authorization details missing or invalid
- Authorization expired
What Typically Happens Next
- Payment is denied or adjusted
- Claim processing completes
- Appeal options may exist
What This Code Is Not
- It is not a billing format error
- It is not patient responsibility
- It is not a contractual adjustment
Troubleshooting Checklist
- □ Review preauthorization requirements
- □ Confirm authorization validity
- □ Monitor payer policies
Notes And Edge Cases
Preauthorization rules vary by payer and service type. Emergency services may follow different rules.
Related Codes
8 links
- CO-197 CodePrecertification required
- CO-167 CodeNo authorization on file
- CO-26 CodeExpenses incurred before coverage
- CO-27 CodeCoverage terminated
- CO-54 CodeMultiple physicians not allowed
- CO-133 CodeIncorrect provider type
- CO-21 CodeMissing/invalid place of service
- CO-33 CodeInsufficient documentation
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