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Elizabeth M. Whitehorn, Director

Provider Notice issued 08/12/15

Chapter R-200, Handbook for Home Health Services Requirement for Billing International Classification of Diseases (ICD)-10-CM Diagnosis Codes Effective October 1, 2015

To:​ Participating Home Health Agencies​
​Date: ​August 12, 2015
​Re: Chapter R-200, Handbook for Home Health Services Requirement for Billing International Classification of Diseases (ICD)-10-CM Diagnosis Codes Effective October 1, 2015​

The HFS 2212 claim form has been revised to accommodate expanded ICD-10 diagnosis coding. Dates of service on or after October 1, 2015 must be billed on the revised form, which has a revision date of R-2-15 in the bottom left corner of the form. The revised form may be ordered from the Medical Forms Request page of the department’s website.

Appendix R-1 of the Handbook for Providers for Home Health Agency Services has been updated and is available on the department’s website. Any questions regarding this bulletin should be directed to a medical assistance consultant in the Bureau of Professional and Ancillary Services at 1-877-782-5565. 

Instructions for updating the Handbook for Home Health Agency Services:

Appendix R-1

Remove pages HFS Appendix R-1 (5) and insert new page HFS Appendix R-1 (5)

             HFS Appendix R-1 (5) (pdf)