Chronic obstructive pulmonary disease (COPD) (POAC)

All Pinnacle practices in Waikato region can claim for this service. 

Patients with an acute or sub-acute COPD exacerbation that can be safely managed in the community

• Any patient with a severe COPD exacerbation including the pre-hospital treatment that has been provided, as admission to hospital is inevitable.
• Mild COPD exacerbation.
• Repeat COPD medication consultations.
• Spirometry. 

Exclusion criteria to access POAC funding should not preclude emergency treatment of any medical conditions.

Once the episode of care is completed and the patient is no longer acutely unwell, they exit the POAC programme.  
 
Once the patient exits the POAC programme, the case requires a clinical outcome to be lodged. No payment can be made for any claims unless the outcome is completed.  

Where treatment in the community is no longer clinically appropriate, the patient may be admitted to hospital during a POAC plan of care. Please indicate this in the clinical outcome.

The initial 15-minute GP/NP consultation incurs the usual consultation fee paid by the patient. All POAC services thereafter are provided at no cost to the patient. If the claim cannot be funded by POAC, the patient may be liable to the practice for the fees incurred. 

Prices listed below are GST inclusive.

Please make your claim via Primary Options, select COPD and then attach the appropriate invoice(s).

GP/NP/CP extended consultation: $79 
To cover an additional 15 minutes of GP/NP/CP time above the initial 15-minute consultation. This invoice can be claimed twice per episode of care to fund a maximum of 30 minutes of additional time. This invoice can only be claimed at the time of the initial consultation.

Rural GP/NP/CP extended consultation: $89 
To cover an additional 15 minutes of GP/NP/CP time above the initial 15-minute consultation. This invoice can be claimed twice per episode of care to fund a maximum of 30 minutes of additional time. This invoice can only be claimed at the time of the initial consultation.

This funding is available to those practices who receive rural funding. 

After Hours GP/NP/CP extended consultation: $100
To cover an additional 15 minutes of GP/NP/CP time above the initial 15-minute consultation. This invoice can be claimed twice per episode of care (acute presentation only) to fund a maximum of 30 minutes of additional time. This invoice can only be claimed at the time of the initial consultation.

This funding can be claimed when care is provided after 5pm, on weekends or on public holidays.

GP/NP/CP follow up: $79 or RN follow up: $39
A follow-up visit may be funded for management post CXR (based on treatment provided as evidenced in clinical notes).

This is limited to one consult within the acute episode of care. While follow up consultations can be virtual, to be eligible for funding, documentation needs to include a two-way conversation between the practice and the patient. A sent message with no documented response does not meet the definition of a consultation.

Rural GP/NP/CP follow up: $89 or RN follow up: $49
A follow-up visit may be funded for management post CXR (based on treatment provided as evidenced in clinical notes).

This funding is available to those practices who receive rural funding. 

This is limited to one consult within the acute episode of care. While follow up consultations can be virtual, to be eligible for funding, documentation needs to include a two-way conversation between the practice and the patient. A sent message with no documented response does not meet the definition of a consultation.

After hours GP/NP/CP follow up: $100 or RN follow up $59
A follow-up visit may be funded for management post CXR (based on treatment provided as evidenced in clinical notes).

This funding can be claimed when care is provided after 5pm, on weekends or on public holidays.

This is limited to one consult within the acute episode of care. While follow up consultations can be virtual, to be eligible for funding, documentation needs to include a two-way conversation between the practice and the patient. A sent message with no documented response does not meet the definition of a consultation.

Funded via third party providers  
A chest X-ray is funded under this service, if clinically indicated, to support management and avoid acute admission. Patients who are not acutely unwell and do not require a same day X-ray are not funded under POAC and should be referred to primary referred radiology.  

Radiology is only funded for same-day investigations (within a 24-hour period). 

Practices are required to provide sufficiently detailed consultation notes to determine appropriate use of POAC funding.  

It has been recommended that in addition to a good assessment and history, the full range of appropriate observations should be documented, especially where the diagnosis is undetermined. It is important to state the time of consultations and interactions with the patient.

The initial 15-minute GP/NP consultation incurs the usual consultation fee paid by the patient. All POAC services thereafter are provided at no cost to the patient. 

The service is funded by Te Whatu Ora. 

In addition to the funded services available via POAC there is another service that general practice can utilise to potentially avoid a hospital admission. 

NB: This service is neither accessed nor claimed through Primary Options. 

Acute COPD Community Escalation Service (ACCESS)

The Acute COPD Community Escalation Service (ACCESS) is a new expert triage, advice and treatment pathway with the aims of rapid assessment and admission avoidance.

Please call the dedicated COPD hotline on 027 202 6208 to speak to the clinical nurse specialist for advice and referral. 

The service is available 8.30am - 5pm, excluding weekends and public holidays.

The ACCESS team is co-ordinated by a respiratory clinical nurse specialist (CNS) and includes a respiratory physician, CNS, physiotherapist and the START team.

START is an intensive home-based rehabilitation service which provides support for those discharging from hospital, presenting to ED or referred from general practice.

If your call is not answered, please leave a brief message including patient NHI, age, name and reason for referral.  All calls will be answered within one hour.

If it is not practical or safe to wait for the call-back, please refer your patient to Waikato Hospital Acute Medical Unit or nearest ED if outside Hamilton.

Referral

• Call 027 202 6208 (you must make a phone call first to access this service followed by an eReferral).
• Send BPAC eReferral to Respiratory-COPD ACCESS.

Eligibility criteria

• Patients with acute or sub-acute presentation of COPD requiring further management and/or support.
• May have associated chest infection/pneumonia/heart failure. If uncertain, please discuss with COPD hotline.

Exclusions

• Acute respiratory failure.
• Acute altered mental status (suggesting hypercapnia) or confusion/delirium.

Any other reasons requiring inpatient treatment (can discuss this with COPD hotline).