Treatment of patients with suspected DVT.
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 Taranaki region can claim for this service.
Exclusion criteria to access POAC funding should not preclude emergency treatment of any medical conditions.
Wells score >=2
Wells score <2
Arrange D-dimer as per HealthPathways.
If superficial vein thrombosis (HealthPathways)
If below knee DVT (HealthPathways)
If superficial venous thrombosis with no risk factors (presence of DVT/superficial venous thrombosis within 3cm of sapheno-femoral junction) and the patient is ambulatory
Total score:
If score is 1 or less, order D-dimer (low risk); If score is 2 or more, refer for ultrasound (high risk).
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 is unable to be funded by POAC, the patient may be liable to the practice for the fees incurred.
Please make your claim via Primary Options, select Deep Vein Thrombosis and then attach the appropriate invoice(s).
Prices listed below are GST inclusive.
DVT prophylactic enoxaparin: $79
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.
Administration of Clexane (pre-scan) when the wait for a DVT USS or d-dimer is longer than 6 hours from initial consult.
DVT negative GP/NP follow up consult: $79
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.
Follow up consult within the acute phase to discuss USS result and alternate diagnosis and treatment. This is limited to one per referral/episode of care.
DVT positive treatment GP/NP: $118
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.
Positive result confirming DVT, extended consult with the GP/NP to discuss diagnosis and develop a care-plan. This is limited to one per referral/episode of care.
NB. This invoice cannot be lodged for a negative DVT result.
DVT positive treatment enoxaparin RN: $79
Positive result confirming DVT, nurse's time for medication review and follow-up consults (only claimable once per referral/episode of care).
NB. This invoice cannot be lodged for a negative DVT result.
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.
URGENT CARE GP/NP extended consultation: $100
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 (acute presentation only) to fund a maximum of 30 minutes of additional time. This invoice can only be claimed at the time of the initial consultation.
ACC DVT prophylactic enoxaparin: $68
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.
Administration of Clexane (pre-scan) when the wait for a DVT USS or d-dimer is longer than 6 hours from initial consult.
ACC DVT positive treatment GP/NP: $79
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.
Positive result confirming DVT, extended consult with the GP/NP to discuss diagnosis and develop a care-plan (only claimable once per referral).
NB. This invoice cannot be lodged for a negative DVT result.
ACC DVT positive treatment enoxaparin RN: $79
Positive result confirming DVT, nurse's time for medication review and follow-up consults (only claimable once per referral/episode of care).
NB. This invoice cannot be lodged for a negative DVT result.
If the ACC DVT scan result is negative but the patient still requires a face to face follow up consult, please claim this as ACC only.
Funded via third party providers
An ultrasound is funded under this service. Patients who are not acutely unwell and do not require a same day scan are not funded under POAC and should be referred to primary referred radiology. The scan can be the next day with Clexane coverage.
GP/NP 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 otherwise the referral may be declined.
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.
Please include a Wells Score as detailed above and/or D-dimer (except in pregnancy and superficial venous thrombosis).
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
Pinnacle has contracts with a number of radiology providers under Primary Options for Acute Care (POAC).
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