Save the date: Cervical Cancer Screening Expansion webinar

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 - WWC table for abnormal cervical results

Question: The ASCCP algorithms for following up after abnormal Pap and HPV results are sometimes difficult to understand, particularly for our new staff members. Is there a cheat sheet of some kind that could assist us with training new staff?

WWC offers a Colposcopy training scholarship announcement

Women’s Wellness Connection (WWC) is pleased to announce a colposcopy training scholarship opportunity that will allow for additional WWC and Title X Family Planning Program (FP) providers to become trained as colposcopists. This scholarship is available to WWC and FP providers that have no experience in colposcopy and for those with experience, but are in need of a refresher.

Attendance performance indicator clarification

In the past, the attendance performance indicator requirement included attendance of one agency representative at 100% of WWC clinical webinars. For this fiscal year, the requirement will include any clinical webinar, training or conference that included topics related to breast or cervical cancer across the cancer continuum. Examples include: ASCCP conferences and patient navigation training. This does not include HIT calls or eCaST User Group calls. If you have questions on whether an educational opportunity qualifies, please contact me, Angie Fellers LeMire.

How to document suspicious vs. non-suspicious CBE findings in WWC

Non-suspicious (normal) includes:

• Benign exam- clinical breast exam (CBE) findings are not a concern for cancer (tenderness, cyclic pain, or fibrocystic may fall into this category)
• Normal or negative exam
• Discrete lump, previously diagnosed as benign. Non-suspicious lumps should still be included in documentation since this is helpful in evaluating change or lack of change at future visits.

Suspicious or abnormal includes:

• Discrete palpable lump (suspicious)
• Bloody, clear or serous nipple discharge
• Nipple or areolar scaliness, rash or color change
• Skin dimpling or nipple retraction
• Inflammation 
• Suspicious breast pain (non-cyclic or pain/tenderness determined by provider to need further diagnostics)

All clients with an abnormal CBE finding should be referred for further diagnostic testing. The provider should indicate whether or not, based on the CBE and patient report, they would like to see additional diagnostics in cases of breast pain or tenderness. If the provider recommends further diagnostic testing in these cases, the CBE results should be documented as “suspicious."

CMEs/CEUs available: HPV vaccination webinar

Join the Pennsylvania Department of Health and the Pa. Immunization Coalition on Jan. 21, 2016 at 10:00 a.m. to 11:00 a.m. MST, for a live one-hour webinar to increase awareness about HPV vaccination and its impact on cancer. This webinar can be applied to the WWC clinical webinar requirement. 

Register online!

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?"

Could clients with Medicare Part B qualify for WWC services as underinsured?

Question: Clients with only Medicare Part A qualify for WWC clinical services. Could clients with Medicare Part B qualify as underinsured if they are unable to pay their co-pay/co-insurance?

Answer: Clients who have Medicare Part B as health insurance are not eligible for WWC clinical services. If they are under 65, however, they can be enrolled in WWC care coordination.

In general, Medicare Part A covers hospital care, skilled nursing facility care, nursing home care, hospice, and home health services. Medicare Part B cover two types of services, medically necessary services and preventive services. Part B will cover a screening mammogram once every 12 months and diagnostic mammography when medically necessary in women 40 or older. Part B also covers Pap tests, pelvic exams, and clinical breast exams every 24 months for all women and every 12 months for those considered high risk for cervical cancer.

Additional information can be found here: https://www.medicare.gov/coverage/your-medicare-coverage.html.

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

Clinical Corner - Cryotherapy Reimbursement

Question: We have a patient that has a history of persistent CIN I and the provider wants to do cryotherapy instead of a LEEP. The provider states that a LEEP is too invasive and cryotherapy is more appropriate. Can we use WWC funds for this procedure?

Answer: Cryotherapy is considered treatment for this patient and WWC funds cannot be used for treatment. WWC reimburses for diagnostic LEEPs only. WWC would not cover the LEEP if it is for treatment purposes.

If you have a clinical question that you would like answered, please email Angela.FellersLeMire@state.co.us.

Webinar: Shared decision-making with low health literacy patients

Registration is open now for a webinar on Dec. 9 from 1:00 to 2:30 p.m. ET that will address how clinicians can effectively engage patients who have limited health literacy skills in shared decision-making. Shared decision-making occurs when a health care provider and a patient work together to make a health care decision that is best for the patient. Research shows that implementation of shared decision-making in clinical practice increases patient satisfaction, enhances patient understanding of their treatment options and increases their involvement in decisions about their care. Yet shared decision-making has not been widely adopted in clinical practice and can be particularly challenging to implement with patients who have limited literacy skills. The webinar will be accredited for continuing education for physicians, physician assistants, nurse practitioners, nurses, pharmacists and certified health education specialists. Determination of continuing education credit through Professional Education Services Group is pending. The webinar is offered via AHRQ’s SHARE Approach initiative, a five-step process for shared decision-making.

Did You Know? Video Series: Informing the public about key cancer statistics

The Did You Know? Video Series provide 2- to 3-minute informational videos on various cancer topics. The videos communicate key statistical data on different types of cancers to a lay audience in understandable, clear, and concise language. Each video also provides background information on cancer types and risk factors, and encourages action when appropriate. Incidence rates, mortality rates, 5-year relative survival rates, geospatial patterns, and other relevant statistics are highlighted in these videos. The data and information shown in this series comes from SEER, the Annual Report to the Nation on the Status of Cancer, gis.cancer.gov, cancer.gov, and other government sources including CDC.

There are currently 16 videos in the Did You Know? Video Series. Some videos focus on specific cancer types such as Leukemia and Thyroid Cancer while others describe overarching topics like Cancer Health Disparities, Cancer Statistics, and Survivorship. Please share these videos and use this as a resource within your networks. Follow the National Cancer Institute's YouTube page or @NCICancerStats on Twitter to stay up to date on the most recent Did You Know? Videos.

Does your agency have a new WWC clinical provider? Are you a new WWC clinical provider?

Welcome to WWC! As a new WWC clinical provider, you will want to become familiar with the Provider Resources web page and Part 4: Clinical Services of the WWC toolkit. These sections of the toolkit include the clinical policies and guidelines that both WWC Clinical Services and WWC Care Coordination programs must follow.