Denial Code CO-119: Description, Meaning and How to Fix It
The patient has hit a benefit maximum (visits, dollars, or occurrences) for the period.
Official description
Benefit maximum for this time period or occurrence has been reached.
Common cause
The plan's benefit cap for the service was already used.
How to fix it
Confirm the benefit maximum at eligibility. If reached, the balance is typically patient responsibility.
Related denial codes
- CO-96: The service is not covered under the plan. Often paired with a RARC explaining why.
- CO-204: The item or service is not a covered benefit under this plan.
- PR-49: A routine or preventive service is not covered (or was billed with a routine exam), and it is patient responsibility.
- N130: The service is subject to plan restrictions; check the benefit documents.
- CO-45: The amount billed is higher than the payer's contracted (allowed) rate. The difference is a contractual write-off, not a patient balance.
- CO-16: The claim is missing required information or has an error. It is almost always paired with a RARC that names the specific missing field.