OakClaim
CO-119Contractual ObligationEligibility

CO-119 Denial Code: Benefit maximum reached

Benefit maximum for this time period or occurrence has been reached.

Why CO-119 happens

  • Visit limits exhausted (e.g., PT/OT visit caps)
  • Annual dollar maximum reached (dental, vision)

How to fix a CO-119 denial

  1. 1

    Verify remaining benefits with the payer

  2. 2

    Bill the patient if benefits are truly exhausted and notice was given

  3. 3

    Appeal with medical necessity if an exception process exists

How to prevent it

Track benefit utilization for capped services and inform patients before the cap.

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