HCPCS Level II code M1114 identifies instances where planned or ongoing services are discontinued early because the patient was hospitalized or scheduled for surgery, with the event documented in the medical record. The code captures care interruptions that occur when clinical circumstances change and continuation of the original service is not medically possible. Nationally, accurate use of M1114 affects claims adjudication, continuity-of-care documentation, and appropriate accounting for partial service delivery across settings such as home health and outpatient care.

Key payers considered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the code's clinical intent and administrative role, common modifiers associated with service discontinuation events, typical sites of service, and guidance on what information is and is not available in the provided input. The publication also outlines the policy and documentation implications of using M1114, including its relevance for billing workflows and claims processing when services end because of hospitalization or scheduled surgery.

This summary is written for a national audience and focuses on the code's purpose, common use cases, and what to expect in terms of documentation and claims handling. Data not available in the input is noted where applicable.