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ADVISORY 2004-13

SUBJECT: Revision of the TWCC-68 and TWCC-70

The Texas Workers' Compensation Commission (Commission) has revised the TWCC-68, Instructions for Completing the UB-92, and TWCC-70, Instructions for Completing the ADA J515 Dental Claim Form. Compliance with the revised TWCC-68, (dated 12-10-04), is required for dates of service on or after April 1, 2005. Compliance with the revised TWCC-70, (dated 12-10-04), is March 1, 2005, but may be used effective immediately. The revisions can be found at

The revisions to the TWCC-68 include the requirement to report the attending and "other" physicians. In addition, a Healthcare Common Procedural Coding System (HCPCS) code is required with a revenue code on outpatient bills when specified in CMS policies. HCPCS codes are required with all CT and MRI revenue codes on inpatient bills. The revisions to the TWCC-70 require use of the ADA J515 dental claim form.

These revisions do not change reimbursement nor do they change the requirements for insurance carrier medical electronic claims submission (ECS) to the Commission. The changes to the TWCC-68 and TWCC-70 update billing requirements for the health care facility and dental provider to the insurance carrier. These changes are a transition step in the Commission's efforts to move the system to electronic billing. Additional details on the electronic billing plan can be found in the Business Process Improvement (BPI) monthly newsletters on the Commission website at ECS requirements for insurance carrier reporting to the Commission can be found at:

Signed this 23rd day of December, 2004

Robert L. Shipe, Executive Director

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