CO 219 denial code

Claim adjustment reason code 219. Often reported as CO 219.

Based on extent of injury

Unofficial reference. This is our own plain-English explanation, not the official code text. Payer rules differ. Verify with the payer and the official X12 code list. AlphaPrefix is not affiliated with X12, CMS or any payer. Data last updated Nov 11, 2026.

What 219 means

The payment was adjusted because the payer decided the service went beyond the accepted extent of the injury.

This is used on injury claims, typically workers' compensation or property and casualty, where the payer has accepted some body parts or conditions but not others.

When the payer reports it, the jurisdictional rule behind it should be identified on the remittance. Treatment for conditions outside the accepted injury is usually the issue.

Group codes seen with 219

On a remittance, 219 comes after a group code. These are the ones it is most often reported with:

• CO 219 (Contractual Obligation): The provider's side of the ledger. The reduction comes from the payer contract or a rule the provider has to follow, and the patient normally cannot be billed for it.

The payer chooses the group code for each adjustment, so the same reason code can appear with another group code on your remittance. Read the two together. More about group codes.

Common causes

• Treatment was for a body part or condition the payer has not accepted as part of the injury.
• The diagnosis codes on the claim do not match the accepted injury.
• The payer is disputing whether a new complaint relates to the original injury.

What to do next

1. Check which body parts and conditions the claim adjuster has accepted.
2. Make sure the diagnosis codes reflect the accepted injury when they truly apply.
3. Send records linking the treatment to the accepted injury if the payer has it wrong.
4. Bill the patient's health plan for unrelated care when the payer's rules allow.

Related codes

• 50 (reason code) Not medically necessary per the payer
• P15 (reason code) Outside workers' comp treatment guidelines