Not legal advice - Denial Decoder helps you understand insurance denials; it doesn't replace a licensed attorney, doctor, or patient advocate.

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CO-119 Denial Code

What it means

You've hit a limit your plan sets on this benefit (e.g., a cap on visits or dollars for the year).

Why it happens

The plan caps how many of a service it covers per year/lifetime, and you've reached it.

What to do

Verify the limit in your benefits. If continued care is medically necessary, appeal for an exception with your doctor's support; some limits have medical-necessity overrides.

Can you appeal it?

Sometimes - via a medical-necessity exception.

Official description

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

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