What CO-119 means
The patient has used the plan's maximum for this benefit for the period, for example visits per year.
The CO group code means this amount is a contractual obligation: under most contracts you cannot bill it to the patient.
Common causes
- Visit or dollar limit exhausted
How to fix it
- Track benefit limits during eligibility checks
- Check for secondary coverage, or bill the patient if they were informed
Check the remark code (RARC) that came with the denial and the payer's own policy, since rules vary by payer and plan. This is a plain-English summary written by GetMax; the official code text is published by X12 at x12.org/codes.
Prevent it next time
Most denials are caused before the claim is sent. See 12 ways to reduce claim denials, or let our denial management team work them for you.