Philhealth Coverage for Kidney Stone Removal

Here are Philhealth coverages for different kinds of kidney stone removal:

 

Code 50590
Extracorporeal Shock Wave Lithotripsy (ESWL)

This is a procedure that uses shock waves to break down kidney stones into
smaller pieces that can be passed or moved out of the body through urine.

Coverage for Professional Fee (PF): 8,400 pesos
Coverage for Hospital Expenses: 9,600 pesos

Total Coverage: 18,000 pesos

Code 50060
Nephrolithotomy; removal of calculus

With this procedure, the doctor removes kidney stones by making a small incision in the patient’s back

Coverage for PF: 15,120 pesos
Coverage for Hospital Expenses: 12,000 pesos

Total Coverage: 27,120 pesos

Code 50065
Nephrolithotomy; secondary surgical operation for calculus

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

Total Coverage: 30,300 pesos

Code 50070
Nephrolithotomy; complicated by congenital kidney abnormality 

Coverage for PF: 15,120 pesos
Coverage for Hospital Expenses: 12,000 pesos

Total Coverage: 27,120 pesos

Code 50075
Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and
calyces (including anatrophic pyelolithotomy)

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

Total Coverage: 37,800 pesos

Code 52320
Cystourethroscopy (including ureteral catheterization; with removal of
ureteral calculus)

Coverage for PF: 5,880 pesos
Coverage for Hospital Expenses: 6,100 pesos

Total Coverage: 11,980 pesos

Code 52336
Cystourethroscopy (with ureteroscopy and/or pyeloscopy (includes dilation of
the ureter and/or pyeloureteral junction by any method); with removal or
manipulation of calculus (ureteral catheterization is included)

Coverage for PF: 6,720 pesos
Coverage for Hospital Expenses: 5,400 pesos

Total Coverage: 12,120 pesos

Code 52337
Cystourethroscopy (with ureteroscopy and/or pyeloscopy (includes dilation of
the ureter and/or pyeloureteral junction by any method); with lithotripsy
(ureteral catheterization is included) 

Coverage for PF: 9,240 pesos
Coverage for Hospital Expenses: 12,700 pesos

Total Coverage: 21,940 pesos

18 Comments

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  1. Hi. Ask lang po ako. My mom is 58 years old. She was diagnosed with kidney stone o her left and right kidneys. Per hospital’s advised, since dependent ko po sya sa medicard ko, and unfortunately,wala po sya philhealth, we need to shoulder 9600 per session para po sa ESWL nya on aug 11 and 13. Total of 19200 po shoulder namin. Ask ko po sana if possible po na matulungan kami ng philhealth khit wala po sya 60 as my dependent po. Phillealth member po ako since 2005 if im not mistaken .your advise will be. Good help to us thnks in advance . God bless

    1. Hi jena, your mom should be at least 60 to be eligible as your dependent. If you like, you can go to Philhealth and ask if your mom can avail if she pays for 1 year in advance. There was a news release about this, but I’m not sure if they’re implementing it. God bless din.

  2. hello is it automatic that my parents can be my dependents when they reached 60 and above even if they were not listed as my dependents with philhealth? thanks

    1. Hi jin, yes and no. You should update your MDR with Philhealth. Bring your ID, birth certificate (proof of relationship) and your parents’ birth certificates or senior citizen IDs (proof of age). Many hospitals require that your parents’ names are written in your MDR.

    1. Hi aljon, ask your surgeon. The costs vary from doctor to doctor. By the way, I’ not a doctor and we’re not working for Philhealth

  3. How much is extracorporeal shockwave lithotripsy. I have kidney stone 15mm in my right and 10mm in my left kidney. thanks much

    1. Hi Cayetano, Philhealth’s coverage for ESWL is 18k (8,400 for pf and 9,600 hospital costs). Ask your surgeon about total cash out if you use Philhealth.

    2. Yung kumpare ko ay may kidney stones. Sabi sa kanya ng doktor na mag-ready ng 100k for operation. Buti na lang at nalaman nya ang USANA. nag-take sya ng products at within 1month ay lumabas ang kidney stones nya at hindi nya na kinailangan magpaopera. Ang galing talaga ng products at nakatipid pa sya.
      Pm me or call me 09255006779
      I’m willing to help you guys.
      We have also a money back guarantee.

  4. hi, my brother is 59 years old and he is now confined and scheduled for removal of kidney stones. he missed payment of his contribution during the first quarter, We paid for this quarter on the day of his confinement, the hospital staff told us that he is not covered. His wife is senior citizen, can he used the Philhealth of his wife as her dependent?

    thanks for your reply

    1. Hi rose, yes, but sorry I’m not sure how Philhealth will treat the latest premium payment by the husband. A person cannot be a Philhealth member and at the same time a dependent. If you decide so, the wife or representative with authorization letter and IDs can go to Philhealth with her marriage certificate to register her husband as dependent. Bring husband’s letter requesting Philhealth to cancel his membership and to register him as dependent of his wife. Then get a new MDR with the husband written as dependent of his wife.

    1. Hi bong, sorry I don’t know specific hospitals. Ask hospitals nearest your work or residence. Philhealth coverage is 9,600 for hospital cost and 8,400 for PF. You pay the balance after deduction. In many government hospitals, you buy the meds/supplies and other hospital costs are usually covered and you pay PF to the surgeon separately.

  5. My Wife is 64 years old and diagnosed that her left kidney had stone measuring more than 3.0 CM. Doctor advice it has to be removed by any of the 3 methods of stone removal. Further advice it need at least 170,000.00 pesos. Will this expenses be covered by Philhealth. Thanks

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