1. (a) Except as provided by subsection (f) of this section, medical bills from all health care providers shall be submitted for payment on the forms prescribed in this section, prepared according to the commission prescribed instructions accompanying each form.
2. (b) Except as provided in subsections (c) and (d) of this section, all health care providers, as defined in the Texas Workers' Compensation Act (the Act), Article 8308-1.03, shall submit bills using the national standard HCFA-1500 health insurance claim form prepared according to the commission prescribed instructions accompanying the form.
3. (c) Hospitals, including hospital-based emergency centers and ambulatory surgical centers shall include the revenue code and submit bills using the UB-82 billing form for institution services and the national standard HCFA-1500 health insurance claim form for professional services, prepared according to the commission prescribed instructions accompanying each form.
4. (d) Pharmacists shall submit bills using Forms TWCC-66a or TWCC-66c, Statement for Pharmacy Services, prepared according to the commission prescribed instructions accompanying each form.
5. (e) Rebilling by the health care provider shall include identical codes and charges as reflected on the original bill. The bill shall be clearly marked "rebill" and shall not include charges for new services.
6. (f) Health care providers not specifically noted in the preceding subsections of this section shall prepare and submit bills in a form and manner prescribed by the commission.
7. (g) The division of medical review will order the health care provider to reimburse a carrier when the health care provider is paid in excess of the amount allowed by the medical policies and fee guidelines established. A health care provider may request a review of those services and charges under the Act, §8.26, no later than 10 days after the division of medical review orders the reimbursement.

Source Note:The provisions of this §134.800 adopted to be effective February 20, 1991, 16 TexReg 671; amended to be effective June 1, 1992, 17 TexReg 3250.