POAC Funded X-Ray

COMMUNITY-ACQUIRED PNEUMONIA (CAP):

CXR funded for mild or moderate CAP (CRB-65 score – 0-1) when the result will facilitate decisions on appropriate immediate management to avoid hospital presentation.

This will usually be when the clinician is unsure of the presenting diagnosis (e.g., chest infection versus heart failure) and is unable to commence appropriate management (eg antibiotics versus diuretics) aimed at avoiding immediate hospital referral.

Not covered by POAC- CXR in CAP for:

·       Severe CAP - CRB - 65 score >/= to 2 (unless recommended/endorsed by a hospital specialist)

·       CAP where the diagnosis has been made clinically and treatment decisions already made (eg starting antibiotics)

SUSPECTED PNEUMOTHORAX:

CXR is funded for clinically suspected pneumothorax not caused by trauma, where immediate admission is not required and it is safe for the patient to attend a radiology provider.

SUSPECTED HEART FAILURE:

CXR is funded when the clinician is unsure of the presenting diagnosis (e.g., heart failure versus chest infection) and is unable to commence appropriate management (eg diuretics versus antibiotics) aimed at avoiding immediate hospital referral.

FOREIGN BODY INGESTED BY CHILD:

See HealthPathway

Asymptomatic child with red flags indicating high-risk foreign body/removal could be time critical, or symptomatic child – CXR funded only if endorsed by a specialist

Asymptomatic child with no red flags -  CXR funded as part of a “nose to whole of abdomen” X ray, if imaging is available with minimal delay and results are viewed straight away.

CXR NOT FUNDED BY POAC (unless endorsed by specialist and required acutely):

·       Suspected pulmonary embolism

·       Suspected inhaled foreign body in a child

Enter your content..FOREIGN BODY INGESTED BY CHILD:

• Refer to the Foreign Bodies Ingested by Children HealthPathway here.

• Asymptomatic child with no red flags -  AXR funded as part of a “nose to whole of abdomen” X ray, if imaging is available with minimal delay and results are viewed straight away.

RENAL COLIC:

• Refer to the Renal Colic and Urinary Stones HealthPathway here.

• KUB X-ray is funded to look for stent dislodgement if a patient with a ureteric stent presents with acute stent symptoms and signs.

AXR NOT FUNDED BY POAC (unless endorsed by specialist, and required acutely): 

·       Constipation in children (refer Constipation in Children HealthPathways here)

·       Constipation in adults (refer Constipation in Adults HealthPathway here)

·       KUB in the initial diagnosis of suspected renal colic.

SUSPECTED SLIPPED UPPER FEMORAL EPIPHYSIS (SUFE):

• Refer to the SUFE HealthPathway here.

• X-ray for a suspected stable SUFE is funded if it can be arranged the same day and the images viewed the same day.

• X-ray is not funded if patient is not stable or if images cannot be both obtained and viewed same day.

SUSPECTED OSTEOMYELITIS OR SEPTIC ARTHRITIS:

POAC funds X-ray for suspected osteomyelitis or septic arthritis ONLY IF discussed with and endorsed by a specialist.

All other Musculoskeletal Xrays are NOT FUNDED BY POAC unless endorsed by a named specialist, and required acutely.

ACC CO-PAYMENT:

• In most situations, injury related x-ray is excluded from POAC and should be under ACC. 

• The exception here is for injury cases initiated by St John, hospital, Emergency Q Voucher or ARC/hospice for portable x-ray for immobile patients requiring acute radiology to exclude fracture and determine admission requirements.  In these situations, POAC will fund the ACC co-payment only.

ACC CO-PAYMENT:

In most situations, injury-related x-rays are excluded from POAC and should be under ACC funding. 

The following are exceptions where POAC will fund the ACC co-payment:

• Injury cases initiated by St John, Hospital ED, Emergency Q Voucher

• ARC/hospice for portable x-ray for immobile patients requiring acute radiology to exclude fracture and determine admission requirements.