PHIC PHILHEALTH CIRCULAR NO. 10, S. 2009, March 17, 2009

[ PHIC PHILHEALTH CIRCULAR NO. 10, S. 2009, March 17, 2009 ]

REVISED VALUE SCALE FOR 2009 WITH ADDITIONAL PROCEDURES

PhilHealth is mandated by law to adapt to changes in medical technology to meet the needs of its members. As stated in Section 39 of the Implementing Rules and Regulations of RA 7875 (as amended by RA 9241) PhilHealth shall introduce additional benefit items and continuously improve the system for benefits availment.

Pursuant to PhilHealth Board Resolution No. 1207 series of 2009, amendments to the RVS 2001 include:

1. Fifteen additional procedures to wit:

CODE

DESCRIPTIVE TERMS

RVU

31636

Bronchoscopy; diagnostic, (flexible or rigid), with placement of bronchial stents

100

31643

with placement of catheters for intracavitary radioelement application

100

52649

High intensity focused ultrasound (HIFU) of the prostate including transurethral resection of the prostate (TURP)

250

55101

Drainage and debridement of Fournier’s gangrene of the scrotum

25

58750

Tubotubal anastomosis

100

59814

Manual vacuum aspiration for spontaneous abortion

50

65780

Ocular surface reconstruction; amniotic membrane transplantation

200

65781

limbal stem cell allograft (e.g., cadavaric or living donor)

200

65782

limbal conjunctival autograft (includes obtaining graft)

200

66982

Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (e.g., iris expansion device, suture support for intraocular lens, or primary posterior capsullorhexis) or performed on patients in the amblyogenic developmental stage

200

67027

Implantation of intravitreal drug delivery system (e.g., ganciclovir implant), includes concomitant removal of vitreous

170

68371

Harvesting conjunctival allograft, living donor

120

75757

Angiography, fluorescein (eye)

50

92980

Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic interventions, any method; single vessel

200

92981

each additional vessel

200

2. Revision of relative value units (RVU) of selected procedures currently found in the RVS will be revised as listed in the attached Annex [*] of this Circular.

3. In addition, to properly guide all concerned in the implementation of this circular, the ground rules for RVS 2001 shall remain in effect until its revision.

This Circular shall take effect for all claims starting April 1, 2009 admissions. All other issuances inconsistent herewith are hereby modified or repealed accordingly.

Please be guided accordingly.

Adopted: 17 March 2009

(SGD.) DR. REY B. AQUINO

President and CEO

[*] Text Available at Office of the National Administrative Register, U. P. Law Complex, Diliman, Quezon City.