Funding for this service is available to patients who hold a Community Services Card,are Māori or Pacific ethnicity or reside in quintile 5. Only one of these criteria need to apply. Other eligibilty criteria (triaged by teledermatology) still apply.
This service provides funding for excision of suspected skin cancers referred from a GP/practice to, and recommended for removal by, the Waikato DHB’s Tele-dermatology Service, or by the dermatologist from the MolemapTM service.
The suspected lesion is referred by the GP to Waikato Teledermatology, or by the dermatologist from the MolemapTM service.
Teledermatology/MolemapTM determines whether the lesion is malignant and whether it is appropriate for excision in primary care.
This information is messaged back from Teledermatology to the referring practice/GP for excision. Molemap referrals will be contained in the Molemap TM patient advice.
The lesion is removed by the referring GP if they are confident to do so, otherwise the patient can be referred to a fellow GP.
To ensure patients receive care close to home, a referral can be made across PHOs.
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.
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 general practices in Waikato can refer into and/or deliver the services.
It is expected that GPs with FRNZCGP qualification will have basic minor surgery skills and dermoscopy skills and should be able to undertake simple excisions (basic level – see below) in a primary care setting.
GPs who have undertaken further surgical training (they may have previously worked in hospital surgical departments, have completed specific postgraduate training or be experienced GPs with significant experience in minor surgery and targeted CME), and participate in regular minor surgical updates, peer review processes or regular audit of surgical practice can deliver the advanced excisions.
GPs offering advanced procedures are expected to take part in a quarterly peer review group to facilitate learning, further training, peer review and audit.
If preferred, a GP can refer the patient to another GP who has a special interest or specific skill in skin lesion excision; this referral can be to any listed GP, irrespective of PHO. See below for referral options.
The service funds excision of lesions as recommended by Waikato Teledermatology/Molemap TM. This includes all consumables and follow up.
Prices listed below are GST inclusive.
Basic level: $287.50
It is expected that GPs with FRNZCGP qualification will have basic minor surgery skills and dermoscopy skills and should be able to undertake simple/basic excisions in primary care setting.
This would include:
Exclusions to basic level:
Advanced level: $517.50
Excisions provided by GPs who have undertaken further surgical training - they may have previously worked in hospital surgical departments, have completed specific postgraduate training or be experienced GPs with significant experience in minor surgery and targeted CME - and participate in regular minor surgical updates, peer review processes or regular audit of surgical practice.
These GPs would self-identify as having the skills to complete more complex surgery in primary care and have a suitable facility to provide this service.
This would include:
Exclusions – to be referred:
Multiple excisions
Where a patient presents with two lesions for excision, the second excision can be claimed at half the fee.
A register of practices will be kept of practices and GPs willing to accept referrals from other practices for both the basic and advanced surgical options. The details of these practices are shared with all PHOs in the region to facilitate interactions, peer support and inter-practice referral.
An inter-practice referral system is in place so that practices who do not have the capacity or capability can refer directly to another local practice. It is expected that any GP or practice accepting referrals will have the capacity and capability to offer both basic and advanced excisions.
You can refer to a listed GP from another Waikato PHO where that is more convenient for the patient. Practices accepting referrals from other PHOs are listed in the BPAC referral form.
GPs accepting referrals for this service are available in the BPAC referral.
If you would like to be added to the register of GPs and practices accepting referrals, please contact the practice systems support team for more details.
Any patient enrolled in a Pinnacle practice and domiciled in the Te Whatu Ora Waikato region is eligible.
If being referred to a fellow GP for lesion removal, any GP or practice listed as accepting referrals can deliver the service on referral from a Waikato GP.
Funding for this service is available to patients who hold a Community Services Card,are Māori or Pacific ethnicity or reside in quintine 5. Only one of these criteria need to apply. Other eligibilty criteria (triaged by teledermatology) still apply.
Patients whose lesion is excluded based on the exclusions below, or where Teledermatology considers the lesion not appropriate for excision in primary care.
Exclusions - basic level:
Exclusions - advanced level:
Patients domiciled outside the Te Whatu Ora Waikato region are not eligible for the service.
The excision is to be completed within 14 days of initial referral.
The claim covers the procedure and includes all consumables and follow ups as necessary. It is expected that follow up is complete by a standard six weeks.
Prices listed below are GST inclusive.
Basic excision: $309.58
Advanced excision: $568.93
For example, if the patient has one advanced and one basic lesion for excision, the claim would be $568.93 for the advanced excision, plus $154.79 for the basic excision.
You will be asked to provide basic demographic information (NHI, age, gender, ethnicity).
You will also be asked to provide:
The system will also collect:
Services are provided at no cost to the patient with no GMS clawbacks. The cost of the procedure includes all consumables and follow ups as necessary.
The initial consultation is not included in the service funding; patients can be charged for that consultation.
The service is funded by a service contract with Te Whatu Ora Waikato.
Jo Scott-Jones, Clinical Director
drjo@pinnacle.health.nz
027 475 0488
Referral pathway for basic and advanced excisions of suspected skin cancers in the Waikato region.
Guide to creating an eReferral to the suspected skin cancer lesion excision service.
BPAC coordinator manual for skin lesion eReferrals.
Manual claim form for suspected skin cancer excision service (Waikato).
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