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CARC
CO-119
CARC
CO — Contractual Obligation
Non-Covered
Quick Facts
Code
CO-119
Type
CARC
Category
Non-Covered
Status
Active
Benefit maximum for this time period or occurrence has been reached
What Does This Code Mean?
The patient has exhausted the plan’s benefit limit (visit count, dollar cap, or occurrence limit) for this service type.
Common Causes
- Visit limit reached (e.g. therapy sessions per year)
- Annual maximum for a specific benefit category met
- Lifetime maximum reached
Recommended Next Steps
- Confirm the specific benefit limit and usage with the payer
- Check if secondary insurance covers the remainder
- Bill the patient for services beyond the covered maximum per policy
- Track high-utilization benefit categories proactively for future patients
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Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.