Philhealth Deduction for Endoscopy of the Stomach

ENDOSCOPY is mainly a diagnostic procedure. Your doctor uses an endoscope to examine your digestive tract and evaluate bleeding in your digestive tract, swallowing difficulty, stomach pain, ulcers, gastritis, chronic constipation or diarrhea or polyps in your colon.

An endoscope is a flexible tube with a light and a camera at the tip, inserted through your throat into your
esophagus.

Your doctor will view your esophagus, stomach and the upper part of your small intestine on a color monitor.
The endoscope can also be used to collect tissue for biopsy.

Philhealth Coverages for Upper Gastrointestinal Endoscopy

Code 43234
Upper gastrointestinal endoscopy, simple primary examination with small diameter flexible endoscope
Code 43235
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum,
diagnostic procedure with or without collection of specimen(s) by brushing or washing
Code 43239
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum, with
biopsy, single or multiple
Total coverage: 10,540
For PF: 5,040
For Hospital costs: 5,500

 

Code 43250
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate; w/ removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery
Total coverage: 11,980
For PF: 5,880
For Hospital costs: 6,100

 

Code43241
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with transendoscopic tube or catheter placement
Code 43251
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
Total coverage: 12,120
For PF: 6,720
For Hospital costs: 5,400

 

Code 43243
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with injection sclerosis of esophageal and/or gastric varices
Code 43244
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with band ligation of esophageal and/or gastric varices
Code 43247
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with removal or foreign body
Code 43255
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with control of bleeding, any method
Code 43259
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with endoscopic ultrasound examination
Total coverage: 14,960
For PF: 7,560
For hospital costs: 7,400

 

Code 43245
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with dilation of gastric outlet for obstruction, any method
Code 43246
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with directed placement of percutaneous gastrostomy tube
Code 43248
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with insertion of guide wire followed by dilation of esophagus over guide wire
Code 43249
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with ballon dilation of esophagus (less than 30 mm diameter)
Code 43258
Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as
appropriate, with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy
forceps, bipolar cautery or snare technique
Total coverage: 18,000
For PF: 8,400
For Hospital costs: 9,600

Read more:

Philhealth Deduction for Colonoscopy

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