Hepatitis C

Any Pinnacle practice in Tairāwhiti can offer and claim for this service. 

The service funds one initial contact, a maximum of two 30 minute consults and one extended prescriber consult per patient. The flow chart below demonstrates the process.  

The initial contact may be by phone or face to face and includes discussion with the patient about the service and the condition. The antibody test result needs to be recorded. If this has been done elsewhere, the result is still to be recorded on the practice’s patient management system. 

An initial (30 minute) consultation is indicated if the antibody test is positive. This consultation is to include recording of the PCR result and referral to Fibroscan and/or APRI score. 

If treatment is to be initiated in primary care, as indicated following the Fibroscan/APRI score, a prescriber consult (30 minutes) is funded to prescribe treatment.  

If treatment is prescribed, phone calls are required to check adherence and the impact of any side effects. Repeat blood tests are also required. 

A second follow up (30 minute) consultation with the patient is funded 12 weeks after the completion of general practice prescribed treatment. At this consultation, the repeated PCR result is to be recorded. 

NB: Each of these consults are only claimable once per patient and the follow up consult is only for patients who have completed a course of primary care prescribed treatment. 

First contact flow chart

Patients who have one of the following risk factors: 

• ever injected drugs (once is enough) 
• received a blood transfusion, or blood products, prior to 1992 (in New Zealand) 
• lived, or received medical treatment, in high-risk countries (South East Asia, China, the Middle East, and Eastern Europe including Russia) 
• received a tattoo or body piercing using unsterile equipment  
• ever been in prison 
• born to a mother infected with hepatitis C.

In addition, a list has been provided to general practices of their enrolled patients who have previously had a positive antibody result. This list enables practices to recall these patients.  

Patient pathway

Patients who have a positive antibody test (whether by point of care testing or venepuncture) will need to have a PCR (viral load) blood test. If this is positive, they will need to be referred for a Fibroscan and/or have an APRI blood test in order to determine the course of treatment. Patients with no or minimal fibrosis on Fibroscan or APRI may be referred back to general practice for the prescription of treatment. All other patients will be managed in secondary care. 

Additional patient funding

Any person with a community services card can apply to WINZ for a special grant to assist with their treatment costs. They do not need to pay this money back. They require confirmation of the fact they are eligible for hepatitis C treatment along with an indication of travel costs to access the GP.  

This can also cover any additional GP visits beyond the funded consultations provided by this service. 

Patients already receiving hepatitis C treatment from secondary care. 

The package of care is outlined in the claiming guidelines. 

There is only one of each consultation type funded per patient. 

No patient co-payment can be charged for any of the funded consultations. 

One of each consultation type per patient – please refer to flow chart under service components.  

Prices listed below are GST inclusive. 

Initial contact: 15 minutes - $20.13 
Discussion with patient, antibody test ordered and recorded.       

Initial consult: 30 minutes - $43.13 
PCR ordered and recorded, APRI recorded, Fibroscan ordered prn.        

Prescriber consult: 30 minutes - $86.25 
Prescribe treatment, will need phone calls to order bloods, to monitor side effects and check adherence.           

Follow up consult: 30 minutes - $43.13 
Face to face 12 weeks after treatment completed, repeat bloods. 

• A claim form is loaded into your PMS. 
• In Indici the service will be visible under funded services to the right of your patient palette.  
• In MedTech the service can be accessed via an advanced form. 
• Submission of the form will generate a claim. Completion of the claim form is sufficient documentation to lodge a claim.  

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

No patient co-payment can be charged for any of the funded consultations. 

Any person with a community services card can apply to WINZ for a special grant to assist with their treatment costs. They do not need to pay this money back. They require confirmation of the fact they are eligible for hepatitis C treatment along with an indication of travel costs to access the GP.  

This can also cover any additional GP visits beyond the funded consultations provided by this service. 

The service is funded by Te Whatu Ora.