Question & AnswerQ&A (PHIC PHILHEALTH CIRCULAR NO. 03, S. 2003)
The circular serves as an addendum to the Relative Value Scale (RVS) 2001 by adding additional compensable surgical procedures and services, including their corresponding codes and relative value units (RVU), effective from January 1, 2003.
Relative Value Units (RVUs) indicate the relative complexity and value of surgical procedures for claims processing and reimbursement under PhilHealth. The circular provides specific RVUs for new and amended procedures.
The amendments are applicable to all claims with discharge dates starting January 1, 2003.
The circular amends code 77401 to be used only for external beam radiation treatment delivery with an RVU of 10, and introduces a new code 77761 for brachytherapy (radioelement application), with an RVU of 20.
Procedures such as mastectomy for gynecomastia, closed treatment of coccygeal fracture, suture of tracheal wounds, insertion of cardiac electrodes, exchange transfusion, and several eye-related surgeries, among others, were added with specific RVUs listed.
Appendectomy (code 44950) and laparoscopic appendectomy (code 56315) were assigned an RVU of 100, while cholecystectomy (code 47600) and laparoscopic cholecystectomy (code 56340) were assigned an RVU of 180.
All other circulars consistent with this circular remain in full force and effect, indicating that this circular supplements but does not repeal previous consistent circulars.
PhilHealth Board Resolution No. 506, s. 2002, authorized the amendments and additions to the RVS 2001, which this circular implements.
No, code 77401 is only for external beam radiation treatment delivery. A new code 77761 was introduced for brachytherapy procedures.