This service provides funding for excision of suspected skin cancers referred from general practice to, and recommended for removal by, the Te Whatu Ora Tairāwhiti teledermatology service.
The service provides safe and effective procedures for patients, closer to home, more quickly for the patient and at less cost for the system.
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.
Any practice in Tairāwhiti 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 suitably experienced clinician.
The service funds excision of lesions which previously would have been performed in secondary care.
Where a patient presents with more than one lesion for excision, a second and third excision can be claimed at half the fee, provided teledermatology approval has been given for all lesions.
Any patient domiciled in the Te Whatu Ora Tairāwhiti region, who has had the removal of their lesion by primary care approved by teledermatology.
Patients whose lesion has been determined by Teledermatology to not be appropriate for excision in primary care.
Out of region patients do not have funding provided under this programme.
Lesion removal for cosmetic reasons
The excision is to be completed within 28 days of initial referral.
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 complications may not be apparent until the time of removal of sutures, we ask that you submit the claim after the sutures are removed.
The prices listed below are GST inclusive.
Please select the advanced form for Suspected Skin Cancer Excision to lodge your claim.
Skin lesion excision: $287.5
Multiple excisions carried out together
One excision can be claimed at the full amount, subsequent excisions performed at the same time can be claimed at half the rate.
Two lesion excision: $431.25
Three lesion excision: $575.00
These consultations cover all time and consumables and there can be no extra charge to the patient.
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.
Practices are required to complete all fields of the claim form to determine appropriate use of funding.
You will be asked to include with your claim:
A patient co-payment cannot be charged for the excision.
The initial consultation is not included in the service funding; patients can be charged for that consultation.
The service is funded by Te Whatu Ora - Tairāwhiti.
Sally Newell, Regional Support Manager - Clinical Contracts
sally.newell@pinnacle.health.nz
021 150 8788
Referral pathway for basic and advanced excisions of suspected skin cancers in the Tairāwhiti region.
MelNet is hosting an eight-week online series, Wednesday 4 October - Wednesday 22 November 2023, to overview the clinical and dermatoscopic characteristics of non-melanoma skin cancers with the aim of increasing your ability to recognise and detect non-melanoma skin cancers early.
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