Clinical Corner - Second Biopsy Case

Question: We have a 44 year old that had multiple suspicious masses that were noted as microcalcifications on her mammogram report. Her ultrasound reports noted 5 hypoechoic masses with irregular margins and a Birads-5 result. Patient proceeded to have two left ultrasound guided core breast biopsies and a left breast ultrasound guided lymph node biopsy. Now that WWC will reimburse for a second breast biopsy on the same day, what should we enter in eCaST for proper reimbursement on this case?

Clinical Corner: IDC vs. DCIS

Question: What is the difference between IDC and DCIS?

Clinical Corner - Normal CBE & No Screening Mammogram? What do you do!

Question: We have a client who had a normal clinical breast exam (CBE) and did not present with any symptoms or history of breast cancer. She is 54 years old and her last screening mammogram was in 2011. We provided education about a referral to another screening mammogram. She did not complete the screening mammogram. We attempted to contact her without success. Should this person be closed out as “Lost to Follow-up” in eCaST or “Follow Routine Screening?"

University of Colorado - Buffs’ Play4Kay game

The University of Colorado Athletic Department's Women’s Basketball team is joining the Play4Kay initiative. The Buffs’ Play4Kay game benefiting breast cancer awareness coming up in a couple of weeks and they have three big events happening during the game:

1.  CU will be honoring breast cancer survivors by giving them and their families/friends free tickets and then honoring them during halftime of the game with an on court ceremony

• Survivors can register for the game/request their tickets by either visiting CUBuffs.com/pink or emailing CUPromos@colorado.edu.

2.  CU will be handing out pink CU Women’s Basketball t-shirts to early arriving fans.

3.  The Buffs are raising money for the Play4Kay organization through their team page. 

View the event flyer for more information. 

Updated maps on breast and cervical cancer screening and late stage incidence

CDPHE has updated its maps showing breast and cervical cancer screening (Pap test or mammogram) compliance and late-stage cancer incidence by health statistic region. Each map shows WWC clinical services sites and quantifies screening rates into four groups (depicted by circles) and late stage cancer incidence by shading of regions. These maps should be used to identify geographic areas of additional need for cancer screening and early detection. For more information on these maps and how they can be used, please review the end of Health Improvement Team (HIT) call from February 2015.

Clinical Corner: Evaluating clients with a past history of breast cancer

Question: Currently, we are allowed to reimburse for evaluation of clients with a past history of breast cancer after treatment is complete. What are the parameters and/or time periods allowed for "after completing treatment?"

Training opportunities at the National Consortium of Breast Cancers (NCBC)

Below are a couple training opportunities that will be available at the NCBC 26th Annual Interdisciplinary Breast Center Conference. The conference is April 9-13, 2016 in Paris Las Vegas.

Dr. Harold P. Freeman
Patient Navigation Institute
Navigation Review Course
Tuesday, April 12, 2016  8:00 a.m. - 4:45 p.m.

Presented by:

• Harold P. Freeman, MD
• Rebecca Crane-Okada, PhD, RN, CNS, AOCN
• Courtney Bowen MS

Healthcare professionals and advocates including but not limited to nurses, radiology technicians, other licensed providers and non-licensed navigators will be presented with the most current information on navigation of breast patients across all phases of the healthcare continuum including outreach, screening, diagnosis, treatment and survivorship.

The curriculum will include various modules of navigation which will familiarize participants with the skill sets required to navigate breast patients through various phases of the health care continuum. The trainees will be provided with pertinent information in preparation of the NCBC certification examination.


Breast Patient Navigator Certification
Tuesday and Wednesday April 12-13, 2016 7:30 - 11:30 a.m.

The Breast Patient Navigator Certification has been developed to set standards of achievement and the professional's role; enhance patient safety; improve the quality of care and delivery of services; and recognize professionals who advance beyond basic knowledge in a field of specialty. The Breast Patient Navigator Certification validates the medical professional's knowledge and performance standards through testing. Certification reflects an individual's achievement beyond licensure requirements and a basic level of knowledge. It exhibits dedication to validating a specific set of skills to provide enhanced care and services for patients and clients through advanced competency.

Core Committee Members are:

Imaging: Andrew Newman, MS(M), RT(T), CN-BI
Management: Janell Clark-Brown, MSN, APN-BC, CN-BP, CBEC
Advocate: Becky Olson, BA, CN-BA
Clinical: Julie Schisler, LPN, BS, CN-BC
Provider: Cathy Cole, NP, MPH, CN-BP
Nurse: Colleen Sullivan-Moore, RN, CNN, CN-BN
Community Liaison: Linda Kramer, BS
Chair: Melissa Hopkins, RN, BA, CN-BN
Medical Advisor: Dr. John Bell, MD, FACS
Medical Advisor: Dr. Ernie Bodai, MD, FACS
NCBC Staff Manager: Jennifer Cobb-Hayes, MSM, Ed.D (ABD)

View the conference brochure

Visit the registration web page

New breast cancer risk assessment tool

A new online tool, Breast Screening Decisions, has been made available to assist average risk women 40-49 in deciding whether a screening mammogram is right for them.

The tool gives women in their 40s an individual breast cancer risk assessment and then uses easy-to-understand infographics to show what is likely to happen across a population of similar-risk women. The decision aid is not meant to drive women toward or away from mammography, but to help them make an informed decision. The tool is based on the data the USPSTF used to develop their 2009 recommendations. You can read more about this tool in a NPR article.

The National Cancer Institute’s Breast Cancer Risk Assessment Tool is also an evidence-based screening tool (recommended by WWC) that can be used to determine risk.

Webinar: Breast Cancer. Genetic Counseling. A Firsthand Account

Date and time: Wed, Nov 11, 2015 12:30 PM - 2:00 PM MST

"I was diagnosed in June 2013 when my son was 18 months old. After I stopped breastfeeding one of my breasts did not go down, which is abnormal, so I got my mammogram. I was devastated when I got my diagnosis of breast cancer." 

Join the Office of Minority Health Resource Center and Dr. Lori Wilson, Howard University Hospital & College of Medicine Surgical Oncologist and Surgery Residency Program Director, for a presentation on her personal experience with cancer. PPEs will learn about Dr. Wilson's unique firsthand experience with cancer as an oncologist and a patient. Nicole Thompson, genetic counselor, will provide lessons on genetic counseling. Both will be available to address all questions.

Register now.

Ford partners with Lyft to provide free rides to treatment

Ford has partnered with Lyft, a peer-to-peer ridesharing program, on an initiative that will allow anyone in Lyft’s 60 US markets to request a free ride to and/or from breast cancer treatment. Patients that would like to request a ride can visit lyft.com/moregooddays and click “get a ride” or “give a ride." Please share this information with your local communities and help Ford reach its goal of 10,000 rides!

Furry friends take on Breast Cancer Awareness Month

October is Breast Cancer Awareness Month. Here at CDPHE we LOVE our furry friends!

Does your agency need any of the following (free) materials?

• WWC marketing materials
• Breast health flip books
• Make it Your Own (MIYO) communication

Can you guess which animal belongs to which WWC team member? What are you doing at your agency to raise awareness? Share ideas below!

Clinical Corner - 3D Mammography Reimbursement

Question: Does WWC reimburse for 3D mammography (i.e. tomosynthesis)? What are the tomosynthesis CPT codes we should be aware of?

Study: False-Positive Mammogram Result and Psychosocial Consequences

Currently, mammograms are one of the best methods for detecting breast cancer at an early stage. We also know that side effects from mammography screening can occur. This article from MedlinePlus, a website from the U.S. National Library of Medicine, discusses the rate of five psychosocial consequences that occur due to false-positive mammogram results. The article is based on a Swedish study published in Cancer Epidemiology, Biomarkers & Prevention (August 2015). WWC’s guidance includes having a detailed conversation with patients to discuss potential harms and benefits, before referring for screening mammography. This is particularly important in women 40-49 years of age.

7 (FREE) Cervical and Breast Screening Podcasts

Are you in need of brief, but informative cervical, HPV and/or breast screening podcasts for staff training or patient education? Below is a list of podcasts that may be helpful. They range between 1:15 and 8:14 minutes in length and can all be found on the CDC’s website.

A Brand New B7 for CCGP!

Hello CCGP eCaST Users ☺   It’s your Data Coordinator, Nick Roth, here with a reminder on the changes coming to CCGP billing levels.  

Many of you provided feedback on lack of payment for CCGP cases when no mammogram is provided. We have heard you and are adding a new CCGP B7 level to reimburse $15 when health education and/or a clinical breast exam (CBE) are completed without a mammogram. The new bundles will look like this:

Level	Services	Payment
B 7	Patient navigation to a completed breast cancer screening office visit.	$15
B 8	Patient navigation to a completed screening mammogram.	$45
B 9	Case management to a final diagnosis. The final diagnosis may be cancer or non-cancer.	$105

Follow me on this one: 

Those cases with an error which used to be deleted due to the client not coming in for their mammogram after their CBE will now instead achieve a B7 pay out! 

What used to be a B7, will now be a B8… and you guessed it, the former B8 will become the brand-new level B9! 


The Takeaway:  Do not worry about the CCGP error “CCGP breast screenings must have a mammogram,” as this error will eventually, magically turn from a dreaded red triangle to an awesome green box with a 7 in it!

Note:  this transition with be retroactive to June 30, but applies only to fiscal year 2016 clients, so only clients with CBEs on July 1, 2015 to present. 

One more thing:  Have a lovely day!