OakClaim
CO-149Contractual ObligationEligibility

CO-149 Denial Code: Lifetime maximum reached for this benefit

The patient exhausted the lifetime maximum for this specific service/benefit category (distinct from CO-35's overall lifetime max).

Why CO-149 happens

  • Benefit-specific lifetime caps (e.g., infertility, bariatric, hearing aids) reached

How to fix a CO-149 denial

  1. 1

    Verify accumulator history with the payer; appeal if their count is wrong

  2. 2

    Shift to patient responsibility with documented benefit exhaustion

How to prevent it

Check benefit-specific maximums during verification for cap-prone services.

Drowning in CO-149 denials?

OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.

Get a Free Audit

Related eligibility denials