Musculoskeletal (POAC)

All Pinnacle practices in the Te Whatu Ora Lakes area.

• Patients domiciled in Te Whatu Ora Lakes area.
• Adults for suspicion of pathological fracture where there is no history of injury.
• Children aged 8-16 years for suspicion of SUFE (unexplained hip, or knee pain, especially if the hip is internally rotated and flexed). These children require an X-ray AP Pelvis and lateral of the hip. A frog lateral is useful for comparison with the other side if the slip is subtle. 

• Patients not domiciled in Te Whatu Ora Lakes area.
• Suspected septic arthritis, osteomyelitis. The pre-hospital treatment that has been provided cannot be funded via POAC, as admission to hospital is inevitable. Refer acutely to ED/orthopaedics.
• Suspected spinal tumour. Please refer via orthopaedics using the high suspicion of cancer tab.
• Injury related X-Rays/ultrasounds/consultations/procedures – These are funded by ACC.
• Chronic rheumatological conditions management/investigations including joint injections. 

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

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 is unable to be funded by POAC, the patient may be liable to the practice for the fees incurred. 

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

Prices listed below are GST inclusive.

GP/NP/CP follow up: $81.37 or RN follow up: $40.17 or

Rural GP/NP/CP follow up: $91.67 or RN follow up: $50.47 or

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

Afterhours GP/NP/CP follow up: $101.97 or RN follow up $60.77

This funding can be claimed when care is provided after 6pm, on weekends or on public holidays.

A follow-up visit may be funded for management post X ray (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.

Funded via third party providers  
SUFE: An AP Pelvis and lateral X-ray of the hip is funded under this service. A frog lateral is also funded if appropriate for comparison with the other side if the slip is subtle. 

Pathological fracture: X-rays are funded under this service. Patients who 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 otherwise the referral may be declined.   

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.