Antibiotic treatment for patients aged >= 15 years with moderate cellulitis.
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.
All Pinnacle practices in Waikato region can claim for this service.
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 Cellulitis and then attach the appropriate invoice(s).
Oral cellulitis: $79
Maximum of three visits for oral antibiotic management of cellulitis.
The purpose of these visits is to ensure the infection is improving, monitor medication compliance and ensure other comorbidities and social circumstances are addressed.
IV cellulitis: $87 per day
IV antibiotic administration for up to three days where clinician has concerns re adherence/absorption of oral antibiotics.
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.
Note HealthPathways has not yet been updated.
Flucloxacillin
Alternatives
In moderate cellulitis, intravenous antibiotics with probenecid remain an option if the clinician has concerns regarding adherence or absorption. If patient is improving overall at 48 to 72 hours after initiation of oral therapy, do not start intravenous therapy due to the persistence of redness/swelling as this is a normal inflammatory response.
The hospital pharmacy is currently unable to provide oral cellulitis packs similar to the available IV cellulitis packs. In the interim you can choose to either provide your patient with a prescription for oral antibiotics or access the medication via your MPSO system.
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.
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
Business rules for the Primary Options Acute Care programme (Waikato), which supports primary care through funding specific clinical services.
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.
Cellulitis and ACC Cellulitis – IV treatment
Quick guides to assist practices with identifying eligibility criteria;invoices that can be claimed; managing claims and providing assistance with understanding remittance reports
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