POAC Funded X-Ray
Principles of funding: POAC will fund a same-day plain X-ray where ALL of the following apply:
It is safe to manage the patient in the community, AND
Required within 24-48 hours, or patient would otherwise be sent acutely to ED, AND
The result of the x-ray will inform immediate clinical management, AND
The condition is not related to trauma or accident (unless specifically outlined below)
X-ray - Adult
X-ray Chest - Adult
POAC WILL fund X-ray within 24-48 hours, where:
Suspected community-acquired pneumonia (CAP) with unexpectedly severe or atypical presentation, where there is uncertainty that treatment with antibiotics alone is appropriate initial management.
An acute presentation with significant respiratory symptoms and uncertainty as to the cause or causes, where alternative causes require different management e.g. infection versus left ventricular failure.
Suspected small pneumothorax
Significant dyspnoea of unclear cause
Guidance:
In patients with an acute lower respiratory tract infection a chest x-ray does not change the management in most cases.
Refer Auckland Regional HealthPathways:
X-ray Abdomen - Adult
POAC WILL fund X-ray within 24-48 hours where:
Diagnosis of constipation where patient history is unobtainable.
Secondary care clinician or Primary Care Radiology Liaison or radiologist advises referral for acute x-ray
Guidance:
As there is wide variation in the amount of normal faecal residue shown, abdominal X-ray does not reliably diagnose constipation nor should be used for monitoring response to treatment. The sensitivity and specificity of AXR is low in both the diagnosis and identifying underlying cause of bowel obstruction. As a more definitive test, CT is preferable and AXR may result in delays to a more definitive test such as CT.
X-ray Musculoskeletal - Adults
Ankle/Foot
Suspected septic arthritis - POAC funding may be considered within 48 hours where specified by secondary care clinician or Primary Care Radiology Liaison
Spine
Suspected septic arthritis - POAC funding may be considered within 48 hours where specified by secondary care clinician or Primary Care Radiology Liaison
ACC/Injury Related X-ray
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.
Paediatric X-ray
X-ray Chest - Paediatric
Chest x-ray is rarely required in suspected community acquired pneumonia (CAP).
Consider POAC funded X-ray within 24 hours if:
diagnostic uncertainty or atypical presentation
not making expected clinical progress and complications are suspected o recurrent pneumonia symptoms (i.e. suggestive of underlying respiratory disease)
Secondary care clinician, Primary Care Radiology Liaison or radiologist advises referral for same or next day x-ray
Refer Auckland Regional HealthPathways:
X-Ray Abdomen - Paediatric
POAC will fund X-ray within 24-48 hours where:
History of suspected ingestion of a foreign body but type of object is unclear, the child is asymptomatic, there are no red flags requiring hospital admission, and an acute x-ray advised by secondary care specialist or Primary Care Radiology Liaison
Secondary care clinician, Primary Care Radiology Liaison or radiologist advises referral for same or next day x-ray
Guidance:
The majority of ingested foreign bodies (FBs) are low risk objects and can be managed without imaging or intervention.
X-rays, when required, should include neck, chest, and abdomen and with lateral as well as frontal views of the neck and chest.
Refer Auckland Regional HealthPathways:
X-ray Musculoskeletal - Paediatric
Pelvis/Hip
POAC will fund X-ray within 24 hours for:
Child presenting with non-acute symptoms where diagnosis of SUFE is suspected - arrange hip X-ray with AP pelvis film and frog lateral view. Be aware that very early slips may be subtle and missed on X-ray and have a low threshold for seeking orthopaedic advice.
ACC/Injury Related X-ray
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.
Last reviewed: 13 January 2026