PHIC PHILHEALTH CIRCULAR NO. 03, S. 2003, December 12, 2003

[ PHIC PHILHEALTH CIRCULAR NO. 03, S. 2003, December 12, 2003 ]

ADDITIONAL LIST OF COMPENSABLE SURGICAL PROCEDURES AND SERVICES IN RELATIVE VALUE SCALE 2001

Pursuant to PhilHealth Board Resolution No. 506, s. 2002, the following amendments to the RVS 2001 shall be applied to all claims with discharge dates starting 01 January 2003: 1. The following procedures with its corresponding codes and relative value units (RVU) shall be considered as addendum to RVS 2001:

CODE DESCRIPTIVE TERMS RVU

19140 Mastectomy for gynecomastia 30

27200 Closed treatment of coccygeal fracture 90

31800 Suture of tracheal wound or injury; cervical 50

31805 Intrathoracic 200

33210 Insertion or replacement of temporary transvenous single chamber cardiac electrodes 50

33211 Insertion or replacement of temporary transvenous dual chamber pacing electrodes 50

36450 Exchange transfusion, blood 20

49900 Suture, secondary, of abdominal wall for evisceration or dehiscence 100

57452 Colposcopy (vaginoscopy) 10

62230 Replacement or revision of CSF (VP) shunt, obstructed valve, or distal catheter in shunt system 80

66825 Repositioning of intraocular lens prosthesis, requiring an incision 90

66985 Insertion of intraocular lens prosthesis, not associated with cataract removal 130

66986 Exchange of intraocular lens 130

75665 Angiography, cerebral 50

2. The new relative value units (RVU) for appendectomy and cholecystectomy shall be as follows:

CODE DESCRIPTIVE TERMS RVU

44950 Appendectomy 100

47600 Cholecystectomy 180

56315 Laparoscopy, surgical; appendectomy (any method) 100

56340 Laparoscopy, surgical; cholecystectomy (any method) 180

3. RVS code 77401, assigned for radiation treatment delivery by virtue of PhilHealth Circular No. 8, s. of 2002 shall also be amended. Effective for claims with January 1, 2003 discharge date, the said code shall only be used for external radiation treatment delivery while a new code, 77761 shall be used for brachytherapy. The new codes, procedural terminologies and RVU shall be as follows:

CODE DESCRIPTIVE TERMS RVU

77401 Radiation treatment delivery; external beam radiation (Cobalt or Linear Accelerator) 10

77761 Radioelement application; surface, interstitial or intracavitary (Brachytherapy) 20

All other circulars consistent herewith remain in full force and effect.

Please be guided accordingly.

Adopted: 12 Dec. 2002

(SGD.) FRANCISCO T. DUQUE III, MD, MSc President and CEO