Philhealth Coverage for Hysterectomy

 

Here is a list of Philhealth Case Rate coverages for Hysterectomy.

Hysterectomy is a surgery to remove the uterus or womb.

It can be done:

.  abdominally (large incision on the abdomen)

.  vaginally (vagina)

.  laparoscopically (small incision on the abdomen)

Types of Hysterectomies:

1.   Total hysterectomy is the removal of the uterus and cervix.

2.   Total abdominal hysterectomy is the removal of the uterus, cervix, fallopian tubes and ovaries

3.   Subtotal hysterectomy is the removal of only the upper part of the uterus. The cervix is not removed. The fallopian tubes and ovaries may or may not be removed.

4.   Radical hysterectomy is the removal of the entire uterus, fallopian tubes, ovaries and pelvic lymph nodes.  Other organs or parts of other organs may or may be removed.  This is usually done in cancerous cases.

Here are the amounts of Philhealth coverages for different cases of hysterectomy:

Code 58150:
Total abdominal hysterectomy (corpus and cervix), with or without removal of tube or tubes, with or without removal of ovary or ovaries

Coverage for Professional Fee (PF):  12,000 pesos
Coverage for Hospital Expenses:  18,000 pesos

Total Coverage:  30,000 pesos

Code 58152:
Total abdominal hysterectomy (corpus and cervix), with or without removal of tube or tubes, with or without removal of ovary or ovaries, with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type)

Coverage for PF:  12,000
Coverage for Hospital Expenses:  18,000

Total Coverage:  30,000

Code 58180:
Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube or tubes, with or without removal of ovary or ovaries

Coverage for PF:  12,000
Coverage for Hospital Expenses:  18,000

Total Coverage:  30,000

Code 58200:
Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling (biopsy), with or without removal of tube or tubes, with or without removal of ovary or ovaries

Coverage for PF:  12,000
Coverage for Hospital Expenses:  18,000

Total Coverage:  30,000
Code 58210
Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube or tubes, with or without removal of ovary or ovaries

Coverage for PF:  33,600
Coverage for Hospital Expenses:  21,400

Total Coverage:  55,000

Code 58260
Vaginal hysterectomy

Coverage for PF:  16,800
Coverage for Hospital Expenses:  13,500

Total Coverage:  30,300

Code 58262
Vaginal hysterectomy, with removal of tube/tubes, and/or ovary/ovaries

Coverage for PF:  16,800
Coverage for Hospital Expenses:  13,500

Total Coverage:  30,300

Code 58263
Vaginal hysterectomy, with removal of tube/tubes, and/or ovary/ovaries, with repair of enterocele

Coverage for PF:  21,000
Coverage for Hospital Expenses:  16,800

Total Coverage:  37,800

Code 58267
Vaginal hysterectomy, with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type, with or without endoscopic control)

Coverage for PF:  25,200
Coverage for Hospital Expenses:  21,300

Total Coverage:  46,500
Code 58270
Vaginal hysterectomy, with repair of enterocele

Coverage for PF:  25,200
Coverage for Hospital Expenses:  21,300

Total Coverage:  46,500

Code 58275
Vaginal hysterectomy, with total or partial colpectomy

Coverage for PF:  21,000
Coverage for Hospital Expenses:  16,800

Total Coverage:  37,800

Code 58280
Vaginal hysterectomy, with total or partial colpectomy, with repair of enterocele

Coverage for PF:  25,200
Coverage for Hospital Expenses:  21,300

Total Coverage:  46,500

Code 58285
Vaginal hysterectomy, radical (Schauta type operation)

Coverage for PF:  25,200
Coverage for Hospital Expenses:  21,300

Total Coverage:  46,500

Code 59525
Subtotal or total hysterectomy after cesarean delivery

Coverage for PF:  12,000
Coverage for Hospital Expenses:  18,000

Total Coverage:  30,000

 

Source: 

Philhealth Circular No. 35, s-2013
Annex 2: List Of Procedure Case Rates
ACR Policy No. 2 — Implementing Guidelines On Medical And Procedures Case Rates

Disclaimers:

This blog is not administered by Philhealth.  It is a personal blog.

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