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CO-197: Precertification / prior authorization absent

UPDATED JULY 2026 · U.S. PLANS · NOT LEGAL OR MEDICAL ADVICE

The service required prior authorization and the payer has no record of one. One of the most common — and most fixable — denials.

CO-197 at a glance
  • Code group: CO — Contractual Obligation — in-network providers generally cannot bill you for CO adjustments.
  • Who usually fixes it: You and the billing office together.
  • Worth appealing? Yes — commonly appealed.

What to do about a CO-197 denial

  1. Ask the provider whether authorization was obtained; a valid number just gets resubmitted.
  2. If none was obtained, request retroactive authorization — payers grant it more often than people expect, especially for urgent care.
  3. Appeal if retro-auth is refused; authorization failures by the provider are generally not the patient's bill in-network.

Best next read: Prior authorization denials — the full guide (with a free letter template) for this denial type.

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