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(NAR) VOL. 14 NOS. 3-4 / OCTOBER - DECEMBER 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

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