Healthcare Error Code
Healthcare Insurance / Medical Billing
Common CMS / Medicare Issues
M114 | Missing diagnosis
Industry
Healthcare
Canonical
/healthcare/error-codes/m114/
Last Updated
Feb 25, 2026
Summary
This code indicates that required diagnosis information was missing from the claim.
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What This Code Means
M114 is applied when CMS determines that diagnosis information necessary for adjudication was not provided. Diagnosis data supports coverage and payment decisions. This is an administrative completeness issue rather than a coverage denial. The claim may be eligible for reprocessing once diagnosis data is complete.
Where Users Usually See This Code
- Medicare remittance advice
- Claim rejection notices
- CMS claim status reports
Why This Code Appears
- Diagnosis code omitted
- Diagnosis data incomplete
- Submission formatting errors
What Typically Happens Next
- Claim processing stops
- Reprocessing may be required
- Payment is delayed
What This Code Is Not
- It is not a non-covered service decision
- It is not patient responsibility
- It is not a contractual adjustment
Troubleshooting Checklist
- □ Verify diagnosis code inclusion
- □ Review CMS submission rules
- □ Monitor claim status
Notes And Edge Cases
Diagnosis requirements vary by service and program. CMS validation rules are strict.
Related Codes
8 links
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