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Programmes » Suspected skin cancer excision service - Lakes

Suspected skin cancer excision service

Lakes | Preventative | Skin | Under 18 | Over 18 | Over 65

Overview

This service provides funding for excision of suspected skin cancers to an identified group of patients. 

It provides safe and effective procedures for patients, closer to home, more quickly for the patient and at less cost for the system. 

Practices who do not have the capacity or capability can refer directly to another local practice.

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?

Any Pinnacle practice in Taupō/Tūrangi can offer and claim for this service.

Practices can also provide this service to patients enrolled in another practice who may be referred to you. In these cases, you can only invoice for this service and no other off set can be claimed.

The service can be provided by any suitable experienced clinician.

Service components

The service funds excision of lesions which previously would have been performed in secondary care.

Who is eligible for the service?

Patients who are currently on the Te Whatu Ora Lakes waiting list who have been referred back to general practice. Pinnacle will provide each practice with a list of eligible patients.

Who is excluded from the service?

Patients not identified to you by Pinnacle.

When is the service complete?

The claim covers the procedure and includes all consumables and follow ups as necessary. It is expected that follow up will be complete within six weeks.

Please note, that as you are required to include the histology and any complications with your claim, we ask that you submit your claim once the episode of care is complete.

Claiming guidelines

The price listed below is GST inclusive. 

Skin lesion excision: $503.47

These consultations cover all time and consumables and there can be no extra charge to the patient.

Please submit an electronic claim via indici in the usual way.

Please note that if a review of claiming indicates that a claim has been paid for a patient who was not eligible for this service then you will be required to repay the claim.

What level of clinical notes do I need to submit?

Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of funding.

You will also be asked to include the following with your claim:

  • histological diagnosis
  • outcome of excision
  • any complications (i.e. infection or wound dehiscence)
  • whether the patient was referred to secondary care.
Does the patient have to pay?

No. A patient co-payment cannot be charged.

How is the service funded?

The service is funded by Te Whatu Ora - Lakes.

For more information

Sally Newell, Regional Support Manager - Clinical Contracts
sally.newell@pinnacle.health.nz
021 150 8788

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