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Programmes » ACC Cellulitis (POAC) - Tairawhiti

ACC Cellulitis (POAC)

Tairāwhiti | Skin | Under 18 | Over 18 | Over 65

Overview

Antibiotic treatment for patients aged 15 years and older with moderate cellulitis funded by ACC. Oral antibiotic therapy is the preferred option.

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. 

Details

Which practices can claim for this service?

All Pinnacle practices in Tairawhiti region can claim for this service. 

Who is eligible for the service?
  • Patients aged >= 15 years with moderate cellulitis funded by ACC
  • Patients who are systemically unwell with no red flags and no co-morbidities.
  • Patients who are systemically well with co-morbidities such as PVD, diabetes, morbid obesity, chronic venous insufficiency, poor nutrition.
  • Refer to Community management of soft tissue infections for careful patient selection criteria see tips.
  • If needing to extend the course of IV antibiotics for longer than three days – please discuss with infectious diseases specialist and document this in the notes.  
Who is excluded from the service?
  • Patients aged < 15 years.
  • Pregnancy.
  • Septic arthritis/prosthesis present/underlying fracture.
  • MRSA carrier.
  • Administration of IM antibiotics.
  • Incision and drainage of abscesses and associated dressing changes.
  • Post-operative wound dressings.
  • Skin infections e.g impetigo, infected excema, psoriasis
  • Dental infection

Exclusion criteria to access POAC funding should not preclude emergency treatment of any medical conditions. 

When is the service complete?

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. 

Claiming guidelines

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 ACC Cellulitis and then attach the appropriate invoice(s).

ACC- Oral cellulitis: $39

Maximum of two in person visits for oral antibiotic management of cellulitis.

ACC fund the first visit

The purpose of these visits is to ensure the infection is improving, monitor medication compliance and ensure other comorbidities and social circumstances are addressed.

ACC- IV cellulitis: $47 per day  

IV antibiotic administration for up to two days where clinician has concerns re adherence/absorption of oral antibiotics.

ACC fund the first visit

These invoices are a package of care i.e. they include an allocation for staff time as well as consumables, they cannot be claimed along with any other claims. 

If IV antibiotics are administered on day 4 this must be approved by infectious diseases and that approval documented. Additional doses will only be funded if the discussion is clearly documented and included in the case notes. 

What level of clinical notes do I need to submit?

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.

If IV antibiotics are administered on day four this must be approved by infectious diseases and that approval documented. Additional doses will only be funded if the discussion is clearly documented and included in the case notes. 

Does the patient have to pay?

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. 

How is the service funded?

The service is funded by Te Whatu Ora. 

Contact

Primary options team, Pinnacle Midlands Health Network
infoprimaryoptions@pinnacle.health.nz
027 687 7312

RELATED RESOURCES
POAC business rules - Tairāwhiti
Published: 03/08/2020 | Document

Business rules for the Primary Options Acute Care programme (Tairāwhiti), which supports primary care through funding specific clinical services.

View resource
Te Manawa Taki / Midland Region Community HealthPathways
Published: 14/11/2024 | 1 link | Website

A web-based information portal supporting primary care clinicians to plan patient care through primary, community and secondary health care systems within the Midland Region.

View resource
Community management of soft tissue infections
Published: 17/08/2020 | 1 file | Poster

Cellulitis and ACC Cellulitis – IV treatment

View resource | Download files
Primary Options resources
Published: 18/02/2027 | 22 files | Document

Quick guides to assist practices with identifying eligibility criteria;invoices that can be claimed; managing claims and providing assistance with understanding remittance reports

View resource | Download files
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Antibiotic treatment for patients aged 15 years and older with moderate cellulitis funded by ACC. Oral antibiotic therapy is the preferred option.

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