MA114 Denial Code: Latest 2025 Billing & Coding Guidance

In 2025, the ma114 denial code remains a critical issue for medical billers and coders. Understanding this code—and how to prevent or appeal it—ensures smoother claims processing. In this article, you’ll learn what triggers MA114, its impact, and the latest payer rules and best practices as of 2025.

Table of Contents

What Is the MA114 Denial Code?

MA114 is a Remittance Advice Remark Code (RARC) indicating a claim was denied because required service location information was missing, incomplete, or invalid. That includes facility name, street address, city, state, and the ZIP code (especially 9‑digit ZIP+4 when required) :contentReference[oaicite:1]{index=1}.

Why MA114 Still Matters in 2025

Healthcare payers—including Medicare and major commercial insurers—continue enforcing strict location data requirements. Since claims are now submitted via electronic 5010 ANSI format, item 32 on CMS‑1500 or corresponding electronic segments must contain accurate facility address details for all services rendered outside the patient’s home (POS 12) :contentReference[oaicite:2]{index=2}.

2025 Updates and Payer Rules

As of 2025, most Medicare Administrative Contractors still require full valid 9‑digit ZIP code plus the 4‑digit extension per Publication 100‑04 guidelines :contentReference[oaicite:3]{index=3}.
Commercial payers frequently match claims against their location databases. If facility location changes aren’t updated in billing systems, MA114 denials persist.
Denial monitoring automation tools flag MA114 at real time, enabling faster corrections before claim submission.

Common Causes of MA114 Denials

Often, the root causes include:

Missing facility address or ZIP code in item 32.
Incorrect ZIP+4 extension or mismatched payer validation.
Service rendered at a facility not properly registered in the billing system.
Typographical errors or outdated location details.

Preventing MA114 Denials

To reduce risk:

Maintain and audit an accurate facility database with current 9‑digit ZIPs and extensions.
Train staff to validate item 32 entries against facility records before claim submission.
Use EHR or billing software with address validation logic and error flags.
Perform periodic internal audits to catch discrepancies across locations or payers.

How to Handle an MA114 Denial

If a claim is denied with MA114:

Immediately review the remittance advice. Check the address data submitted.
Confirm correct facility information—street, city, state, full ZIP code—from provider scheduling or location management system.
Correct errors and resubmit the claim electronically or via paper form with updated location details.
If the denial is valid but disputeable, consider an appeal with documentation that justifies the location (e.g. contract, lease, or provider location listing).

Example Scenario

For example, a billing team submits a claim where the facility moved, and the ZIP code in item 32 doesn’t match the current valid 9‑digit ZIP on file. The payer denies it with MA114. The team retrieves the updated address, resubmits with the correct ZIP+4, and the claim pays in full.

Related Codes and When They Occur

In workflows, you may see MA114 appear alongside CARC codes:

CARC 5 – Inconsistent procedure code/place of service.
CARC 4 with M114 or N565 when modifiers are incorrect or missing under DMEPOS bidding rules :contentReference[oaicite:4]{index=4}.

Internal & External Resources

Learn more from these authoritative sources:

Internal References on our Site

See our detailed articles on:

FAQ

What ZIP format triggers MA114?

Medicare and many commercial payers require the full 9‑digit ZIP code plus a valid 4‑digit extension if available. Submitting only a 5‑digit ZIP often leads to MA114.

Can MA114 be appealed?

Yes. If the submitted information is correct but denial occurred, you may appeal. Submit documentation showing the provider location is accurate and recognized by the payer.

Does MA114 apply to home visits (POS 12)?

No. MA114 applies only when services are provided in a facility other than the patient’s home or physician’s office. Home visits normally do not require facility address in item 32.

Conclusion

In summary, the ma114 denial code continues to be a common but avoidable error in 2025. Billing teams should audit facility data, validate full ZIP+4 codes, and enforce quality checks in their submission workflows. Additionally, appeal denials when location data is valid. By staying current with payer requirements and internal processes, you can minimize MA114 denials, improve reimbursement rates, and keep your revenue cycle moving efficiently.

Stay proactive: review updates monthly, audit claims, and refer to our resources for denial prevention strategies.