Treatment of patients with abdominal pain, who are haemodynamically stable.
This service is part of the Primary Options for Acute Care (POAC) programme.
Your Pinnacle Services Contract applies to this service. By claiming for this service, you have indicated that you have read and agreed to the business rules set out here.
This is NOT a clinical guideline.
All practices in the Tairāwhiti region can claim for this service.
Patients with abdominal pain, who are haemodynamically stable.
Patients domiciled in Te Whatu Ora Tairawhiti area.
Exclusion criteria to access POAC funding should not preclude emergency treatment of any medical conditions.
Once the episode of care is completed and the patient is no longer acutely unwell, they exit the POAC programme.
Once the patient exits the POAC programme, the case requires a clinical outcome to be lodged. No payment can be made for any claims unless the outcome is completed.
Where treatment in the community is no longer clinically appropriate, the patient may be admitted to hospital during a POAC plan of care. Please indicate this in the clinical outcome.
The initial 15-minute GP/NP consultation incurs the usual consultation fee paid by the patient. All POAC services thereafter are provided at no cost to the patient. If the claim cannot be funded by POAC, the patient may be liable to the practice for the fees incurred.
Prices listed below are GST inclusive.
Please make your claim via Primary Options, select Abdominal Pain and then attach the appropriate invoice(s).
Rehydration: $158
This invoice is a package of care i.e. it includes an allocation for staff time as well as consumables. It cannot be claimed along with any other claims.
or
IV medication: $87
This invoice is a package of care i.e. it includes an allocation for staff time as well as consumables. It cannot be claimed along with any other claims.
Practice observations: $1.00 per minute
Practice observations – maximum 3 hours and based on treatment provided as evidenced in clinical notes. This can be claimed provided no IV administration invoices are claimed. This invoice can only be claimed at the time of the initial consultation.
In-clinic observations can be claimed based on 3 x 10 minute baseline observations per hour.
RURAL practice observations: $1.00 per minute
Practice observations – maximum 3 hours and based on treatment provided as evidenced in clinical notes. This can be claimed provided no IV administration invoices are claimed. This invoice can only be claimed at the time of the initial consultation.
In-clinic observations can be claimed based on 3 x 10 minute baseline observations per hour.
GP/NP extended consultation: $79
To cover an additional 15 minutes of GP/NP time above the initial 15-minute consultation. This invoice can be claimed twice per episode of care to fund a maximum of 30 minutes of additional time. This invoice can only be claimed at the time of the initial consultation.
RURAL GP/NP extended consultation: $89
To cover an additional 15 minutes of GP/NP time above the initial 15-minute consultation. This invoice can be claimed twice per episode of care to fund a maximum of 30 minutes of additional time. This invoice can only be claimed at the time of the initial consultation.
GP/NP follow up: $79 or RN follow up: $39
A follow-up visit may be funded (based on treatment provided as evidenced in clinical notes).
This is limited to one per episode of care within 3 days of the initial consult and cannot be claimed on the day of the initial consult.
RURAL GP/NP follow up: $89 or RN follow up: $50
A follow-up visit may be funded (based on treatment provided as evidenced in clinical notes).
This is limited to one per episode of care within 3 days of the initial consult and cannot be claimed on the day of the initial consult.
GP/NP home visit: $120 or RN home visit: $79
This is limited to one per episode of care within 3 days of the initial consult and cannot be claimed on the day of the initial consult.
Mileage: $0.77 cents per kilometre
Can be claimed in conjunction with a home visit.
Claiming only for third party referrals
An abdominal ultrasound is funded under this service for investigation of acute biliary colic in a haemodynamically stable patient.
Patients who are not acutely unwell and do not require a same day ultrasound are not funded under POAC and should be referred to primary referred radiology. Radiology is only funded for same-day investigations (within a 24-hour period).
GP provided point of care ultrasound is excluded from POAC services – it is expected that patients will be charged for this service.
Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of POAC funding.
It has been recommended that in addition to a good assessment and history, the full range of appropriate observations should be documented, especially where the diagnosis is undetermined. It is important to state the time of consultations and interactions with the patient.
The initial 15-minute GP/NP consultation incurs the usual consultation fee paid by the patient. All POAC services thereafter are provided at no cost to the patient.
The service is funded by Te Whatu Ora.
Primary options team, Pinnacle Midlands Health Network
infoprimaryoptions@pinnacle.health.nz
027 687 7312
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