CO-119CARCCOContractual ObligationPRPatient ResponsibilityAppealability depends
What it means
You have reached a benefit limit for this service in the current period (for example, a yearly visit cap), so no more is covered for now.
Contractual Obligation — an adjustment the provider agreed to by contract. The patient is generally not billed for CO amounts.
Official X12 description
“Benefit maximum for this time period or occurrence has been reached”
Typical cause
Your plan limits how many of this service it covers per period, and that limit has been met.
What to do next
- 1Check your plan's benefit limits for this service.
- 2Confirm the count is accurate — limits are sometimes miscounted across providers.
- 3If the service is medically necessary beyond the limit, ask whether an exception or appeal is possible.