Congestive heart failure - exacerbation (POAC)

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

Patients domiciled in Te Whatu Ora Taranaki area.  

Adults with acute heart failure that can be safely managed in the community.  

• Patients with severe acute symptoms/signs or red flags as indicated below including pre-hospital treatment that has been provided as admission to hospital is inevitable. 
• Patients with mild symptoms or signs.  

• Patients not domiciled in Te Whatu Ora Taranaki area

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

The following may indicate potential life threatening event in patients with dyspnoea. Consider acute referral when any of the following exist: 

• altered mental status  
• hypoxia and cyanosis  
• hypotension  
• abnormal pulse rate and rhythm indicating arrhythmia  
• stridor indicating upper airways obstruction - difficulty breathing without air movement  
• unilateral tracheal deviation and unilateral breath sounds indicating pneumothorax  
• tachypnoea (>40/m) and intercostal/sternal retraction  
• chest pain which may indicate - unstable angina, MI, pulmonary embolism, dissecting thoracic aortic aneurysm, pericarditis, or pneumonia  
• severe orthopnoea  
• severe intractable oedema  
• acute renal failure  
• myocardial infarction within previous two weeks. 

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 Congestive Heart Failure - Exacerbation and then attach the appropriate invoice(s).

IV medication invoice: $89.61
This invoice is a package of care i.e. it includes an allocation for staff time as well as consumables, it cannot be claimed along with any other claims. 

GP/NP/CP extended consultation: $81.37  or

Rural GP/NP/CP extended consultation: $91.67 or

This funding is available to those practices that receive rural funding

After Hours GP/NP/CP extended consultation: $101.97

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

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.

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 (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
A chest X-ray is funded under this service, if clinically indicated. 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.

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.