Healthcare Error Code
Healthcare Insurance / Medical Billing
Common Medicaid / Commercial

CO-119 | Benefit maximum reached

Industry
Healthcare
Canonical
/healthcare/error-codes/co-119/
Last Updated
Feb 25, 2026
Summary

This code indicates that the patient has reached the maximum benefit limit for the service.

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What This Code Means

CO-119 is used when benefit limits defined by the plan have been exhausted. Benefit maximums restrict how much coverage is available within a defined period. This is a plan design feature rather than a billing error. Additional services may not be reimbursed once limits are reached.

Where Users Usually See This Code

  • Remittance advice
  • EOB summaries
  • Benefit utilization reports

Why This Code Appears

  • Annual or lifetime benefit limit reached
  • Service frequency limits exceeded
  • Plan utilization caps enforced

What Typically Happens Next

  • Payment is denied
  • Responsibility may transfer per policy
  • Claim line is closed

What This Code Is Not

  • It is not a documentation issue
  • It is not a duplicate claim
  • It is not a contractual adjustment

Troubleshooting Checklist

  • Review benefit utilization
  • Confirm applicable limits
  • Monitor benefit period resets

Notes And Edge Cases

Benefit limits may reset annually. Different services may have separate limits.

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