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CMS Issues a New Condition Code for Home Health Claims

Posted on Monday, February 15, 2016 12:32 PM

CMS has announced Change Request (CR) 9497 which allows for the following:

  • Adds a new condition code for HH claims
  • Acknowledges unplanned consequences of the new HCPS codes for skilled nursing visits
  • Contains several routine maintenance changes to home health billing instructions manual

CMS will introduce a new condition code 54 “No skilled HH visits in billing period” on July 1, 2016. This will allow HH claims for subsequent episodes to develop without any skilled services. For the full article, please click here.


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