Denial codes / CO-119

Denial code 119

CO-119: Benefit maximum reached

Benefit maximum for this period or occurrence reached.

What to doRead the EOB, then decide
Often recoverableUsually not

The letters in front matter. CO means the office can't bill the patient for the amount; PR means the patient may owe it. The same number can appear with either, so read both parts.

Why dental offices see it

  • The patient used the annual maximum.
  • A frequency limit applied (for example cleanings or bitewings within a set period).
  • The insurer counted a prior service from another office.

What to do

  1. Check the remaining annual maximum and the date of the prior service.
  2. If the insurer is wrong, appeal with dates.
  3. If correct, bill the patient with the EOB.

Stop it next time

Check remaining maximum and service history before treatment, and phase treatment across plan years when it helps the patient.

How many CO-119 claims are in your report? The free check counts them, ranks them by dollars and deadline and drafts the letter. It runs in your browser; nothing is uploaded.

Run the free check

Plain-English paraphrase; the official code list is maintained by X12. Insurer rules vary; check the insurer's provider manual. Not legal advice.