POAC BLOG POST August 2022-important updates
COVID claiming and MoH guidance around acute care-see FAQs and MoH claiming guide for general practice
Accuretic recall –please note the GP funding to change patients to an alternate medication is bulk funded through your PHO. POAC does not fund this activity. Claims received will be deleted.
IV iron HealthPathway –updated dosing June 2022. Single dose 1000mg for all patients over 35kg –see here . This has been confirmed as a safe and effective dose for all patients, irrespective of weight or degree of anaemia.
POAC funded chest X-ray
POAC funds a same day chest X-ray (CXR) to inform the immediate management of a patient. Some examples of POAC-funded CXR include suspected pneumothorax, or suspected pneumonia when the diagnosis is not certain on clinical examination AND to rule out of another diagnosis such as heart failure that will change management.
- POAC does not fund CXR for post viral infection cough or other chronic conditions as these do not prevent a same day ED referral. Claims will not be accepted.
- POAC does not generally fund CXR to look for pneumonia when a clinical diagnosis of chest infection has been made and management already decided (e.g. antibiotics). CXR may be appropriate at some stage e.g. to rule out underlying conditions but, if not required acutely to guide immediate management or prevent admission, needs to be requested via another route.
- Urgent and non-urgent chest x-rays not informing immediate management are to be ordered through Access to Diagnostics, the DHB walk in service, e-Referrals, or private providers. See plain X-ray HealthPathway here.
ACC swallowed foreign body/inhaled substance imaging requests -ACC will fund a plain X-ray when there is suspicion of injury. There is no requirement for a confirmed injury to access funding for imaging. Clinicians must clearly state the suspicion of injury when lodging the ACC claim or the claim is likely to be rejected. Without suspicion of injury, imaging is not funded by ACC.
POAC does not fund X- ray in symptomatic patients.
POAC will fund an X-ray for asymptomatic patients without suspicion of injury where:
- history is unreliable/unknown object; or
- a high risk object has been swallowed or one where removal could be time-critical AND the X-ray can be obtained without delay AND results can be reviewed immediately. See HealthPathway here
Diabetic foot- use of IV antibiotics in primary care for patients with diabetes and active foot disease will only be funded where there is clear documentation of discussion with a named endorsing specialist prior to treatment. Patients simply refusing hospital admission is not a criteria for use of IV antibiotics funded through POAC.
Cellulitis in specific sites and circumstances – a number of special sites or causes of cellulitis, including bite-related cellulitis, hand cellulitis and cellulitis over a joint, can be high risk and require specific management. Please see the Specific case management section of the Cellulitis in Adults HealthPathway. In these situations specialist discussion and endorsement is required for POAC funding of intravenous antibiotics. See here
.Dehydration HealthPathway –A reminder to manage moderate dehydration with a trial of anti-emetic plus oral re-hydration under POAC-funded observation before use of IV re-hydration, where patients are not actively vomiting. IVs are not funded 1st line unless moderately severe dehydration with vomiting at the time of presentation. See HealthPathway here