Denial Code For Benefits Exhausted
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FAQ
For Medicare Plus Blue claims, Explanation of Payment codes 852, 870 and 871 are the only EOP codes that indicate that a claim has been denied for clinical editing.
Reason Code 120: Payer refund due to overpayment. Reason Code 121: Payer refund amount - not our patient.
PR-119 means that the benefit maximum for this time period or occurrence has been met. Providers are reminded that a new year means patients may have made changes to their Medicare coverage.
Your practice might have experienced denial code CO-119. Denial code CO-119 or "Maximum Benefit Reached" is likely the result of reaching this therapy services threshold.
