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03.31.2017

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Windsong Whispers Newsletter Feb 2017

PATIENTS AND THEIR DOCTORS ARE CHOOSING WISELY

In today’s healthcare environment of high deductibles and growing co-pays, referring providers and patients alike are cautiously choosing providers of care, with cost in mind. Windsong Radiology has long been offering a number of treatments in its minimally invasive procedure clinic that are far more affordable when compared to the same service provided in the hospital or ambulatory surgery center.

When considering just patient co-pays, specialist office visits for procedures typically require a $30-50 co-pay compared to the hospital or ambulatory surgery co-pay of $100-500. Hospital charges can be even higher. This savings can be especially signifi cant for patients that must undergo multiple procedures, some of which are noted below.

  • Paracentesis
  • Thoracentesis
  • Mediport placement
  • Phlebectomy

In comparison, some in-offi ce procedures done at Windsong can be up to 50% more cost effective than those performed in other surgical center or hospital settings.

Today’s value-based reimbursement models highly encourage a reduction in wasteful healthcare dollars. Cost effectiveness cannot be the only factor considered, and Windsong Radiology takes great pride in ensuring the right procedure is done on the right patient at the right time, with strong quality controls that lead to the most cost effective outcomes for our patients.

Windsong Radiology’s Interventional Radiology clinic can be reached at 716.929.9484


NY MAMMOGRAPHY ACCESS BILL EFFECTIVE

Women in New York now have an easier time getting a mammogram thanks to Gov. Cuomo’s legislation which expands access to breast cancer screening. This law, which went into effect on January 1, is the most aggressive breast screening legislation in the country and mandates extended screening hours for hospitals and eliminates deductibles and copayments for all screening and most diagnostic imaging.

Many women delay their annual mammograms because of concern over cost and this removes that barrier. Co-pays for all screening mammograms will be eliminated for most diagnostic imaging. Patients across WNY can rest assured that they will no longer incur additional out-ofpocket expenses for common
diagnostic imaging. Dr. Anna Chen, director of women’s imaging at Windsong, said, “Governor Cuomo’s initiatives will increase the chances of early detection. Thanks to this groundbreaking legislation earlier and more effective treatments will save lives.”

The new mandate requires NY administered health plans to cover screening and diagnostic mammograms, screening and diagnostic tomosynthesis (3D mammography), breast ultrasounds, and breast MRIs, with no co-pay, coinsurance, or for patients. While this legislation will cover a vast majority of our patients, it is unclear how Medicare, self-funded and out of area health plans will be handling exams.

As you can see, there will be a number of women who will not have the coverage that the regulation implies. Windsong will work closely with all of your
underinsured patients, and connect them to Cancer Services Program, should the need arise.


CORRECTLY CODING FOR DEXA SCREENING

Practices using EMRs often mistakenly choose the first Dexa bone density code when searching through their EMR. All providers ordering screening bone density exams should use the following code:

  • Bone density CPT code 77080

If there is suspicion of a fracture, you may use the following:

  • Fracture assessment or lateral vertebral fracture CPT Code 77082

Approximately 12 million Americans older than 50 years have osteoporosis and 50% of all postmenopausal women will have an osteoporosis-related fracture during their lifetime; 25% will develop a vertebral deformity; 15% will experience a hip fracture.

Who Should Have a Bone Density Test?

National Osteoporosis Foundation recommends bone density tests for:

  • Women age 65 or older
  • Men age 70 or older
  • Anyone who has broken bone after age 50
  • Women of menopausal age with risk factors
  • Postmenopausal women under age 65 with risk factors
  • Men age 50-69 with risk factors

A bone density test may also be necessary if patients have any of the following:

  • X-Ray demonstrates a patient’s spine has a break or bone loss
  • Patient presents with back pain with a possible spine fracture
  • Patient has had height loss of ½ inch or more within one year
  • Patient has had total height loss of 1½ inches from your original height

If you would like to learn more about bone density testing, please visit the National Osteoporosis Foundation website at http://nof.org/

To schedule an appointment, please call (716) 631-2500.


HAPPY 30TH ANNIVERSARY WINDSONG

This month marks the 30th anniversary of Windsong Radiology. If you don’t know the story, it is a remarkable one. It all began when John and Janet Sung moved from South Korea to America as newlyweds in 1972, arriving in New Jersey with only $200 in their pockets.

On a snowy February morning in 1987 they opened their new radiology practice in a renovated 2,000 square foot Pizza Hut building on Harlem Road. Dr. Sung pioneered face to face results and wanted more for her patients. After a tour of the Mayo Clinic they vowed to create their own version of patient centered imaging. They purchased 6 acres of vacant land on Spindrift in May of 1992, and embarked on making their dream come true.

Awards for clinical excellence, business success and community leadership were abundant over the years. In 1999, Dr. Sung and John Sung established the John and Janet Sung Scholarship Endowment Fund, donating $1 million to the U.B. Medical School.

The Sungs are enjoying a well deserved retirement while Windsong continues to grow – currently employing 19 Radiologists, 2 Breast Surgeons, Nurse Practitioners and Physician Assistants, as well as 270 team members. Its growth is attributed to three things: putting the patient first, working with the latest medical technologies, and continually attracting and retaining the best physicians and team members. Congratulations Windsong!


LOW DOSE LUNG CANCER SCREENING FOLLOW UP AUTHORIZATION

There has been some confusion around how to code for the low dose lung cancer screening follow up exams. Patients only qualify for a fully covered low dose lung cancer CT exam once per year under code G0297. Any 3, 6 or 9 month follow up exam recommendation after the initial low dose CT should be coded 71250 for authorization.


NEW ACCREDITATION ENABLES ALZHEIMER’S RESEARCH

Windsong Radiology Group has been granted PET Brain Accreditation from the American College of Radiology. Up until now, like most PET facilities, Windsong was only accredited for oncology PET. Adding on the Brain module enables Windsong to participate in a number of Alzheimers’ research studies, and paves the way for future diagnostic PET Amyloid imaging once the amyloid isotope becomes available locally.

Windsong joins just one other Buffalo and two other facilities in the Rochester area to carry this distinction. There are only a few in Syracuse, Utica, and Albany with this unique extended accreditation in PET/CT.


GENETIC COUNSELING FAQ

Genetic counseling is quickly being sought after. Windsong’s certified genetic counselor, Laura Fisher, cautions patients about having genetic testing without the appropriate counseling. “Patients must be prepared to understand the implications,” said Fisher. Genetic counseling ensures the right person in the family is tested, the right genetic test is ordered, and the right laboratory is used.

Genetic counseling and testing may be considered for individuals with a personal or strong family history of cancer. Frequently asked questions include:

  1. How much does genetic testing cost? Many insurance carriers cover genetic testing as a preventive service, meaning many patients pay $0, if they qualify.
  2. How much does a visit with a genetic counselor cost? The cost to the patient is similar to the cost of visiting any other specialist.
  3. How long does an appointment with a genetic counselor last? About 1 hour.
  4. What kind of genetic testing does Windsong offer? Cancer genetic testing related to a personal or family history of any type(s) of cancer.
  5. How do we refer a patient? Patients can call 626-6300 to schedule an appointment.
  6. What models are used to calculate lifetime breast cancer risk? After a genetic counseling appt, our genetic counselor has access to 4 different models. The final report will include the range of breast cancer risks based on the different models.

If your patients had genetic testing just a few years ago, they may be eligible for additional testing of newly recognized genes. Today there are nearly 50 genes that can be tested, compared to the BRCA 1 and BRCA 2 genes that many are more familiar with. To learn more, visit windsonghealth.com or call 716.626.6300.


C-VIEW™ SOFTWARE AND PERSONALIZED SCREENING: UNPARALLELED EXPERIENCE MATTERS

As we all know, breast cancer screening has the ability to detect breast cancer at an early stage. When followed up with appropriate diagnosis and treatment, the survival rate is nearly 98%. New evidence demonstrates that women at increased risk of breast cancer may benefit from additional screening technologies. Certain women may benefit from earlier initiation of screening including shorter screening intervals and the addition of other screening modalities such as ultrasound and magnetic resonance imaging (MRI).

The addition of Hologic’s C-View™ software to our screening equipment coupled with its dose reducing capability realizes all the benefits of tomosynthesis at doses comparable to conventional 2D mammography. This technology will be coupled with Windsong’s unique personalized breast screening algorithm which will allow us to offer your patients the highest performance technology with the most comprehensive screening.

Windsong has been utilizing tomosynthesis since its FDA approval in 2011. Windsong Radiologists have utilized this unparalleled duration of experience with tomosynthesis to become the best trained in this new technology. With the added benefit of C-view (synthesized 2D mammogram) with the tomosynthesis, Windsong has taken the needed time to become comfortable with this technology to decrease the false positive rate that can occur with any exam. We feel confident that Hologic’s

C-View™ with tomosynthesis and its lower radiation dose is the best mammogram for a majority of women in which a mammographic exam is indicated.

The new algorithm designed specifically by Windsong Radiology will differentiate screening needs based upon cancer risk accordingly. This algorithm will assist our referring providers with clear determination of what screening tests are appropriate for their individual patients.

All age-appropriate women are recommended to receive a C-View study which is a synthesized mammo/tomo (3D).

Those that are at an intermediate risk (11-19% lifetime risk) and have dense breast tissue are recommended to have the C-view study and screening ultrasound. Those women who are at high risk (have a greater than 20% or higher lifetime risk) are recommended to have the C-view study and a breast MRI.


OUTPATIENT TREATMENT OF PELVIC CONGESTION SYNDROME AVAILABLE AT WINDSONG

Causes of chronic pelvic pain are varied, but are often associated with pelvic varicose veins. It is also known as pelvic congestion syndrome (PCS) when other etiologies are not found such as uterine/ovarian abnormalities.

PCS is similar to varicose veins in the legs. Both result when the valves in the vein become weakened and do not close properly. This allows blood to flow backwards and pool in the vein causing pressure and bulging veins. Since this worsens with sitting/standing (due to backup from gravity, symptoms often worsen throughout the day.

  • Common signs of PCS:
  • Leg/pelvic/buttock pain, aching or cramping
  • Pelvic discomfort and fullness throughout the month
  • Pelvic bloating
  • Pain/aching with and/or after intercourse
  • Pelvic/abdominal tenderness

Symptoms may worsen after standing for long periods of time, following intercourse, during menstrual periods, during or following pregnancy.

If your patients present with irritable bladder, varicose veins on vulva, buttocks or thigh or leg swelling and varicose veins, they may be suffering from pelvic congestion syndrome. PCS can affect anyone but is most common between the ages of 30 and 50 years old. Other factors that may increase risk include history of varicose veins, two or more pregnancies, polycystic ovaries, or hormonal dysfunction.

Windsong Radiology’s Interventional Radiology clinic evaluates PCS with a specialized ultrasound which is performed to evaluate pelvic veins. If treatment is warranted, our interventional team can perform an outpatient minimally invasive procedure using image guidance in our clinic at our Williamsville location. This procedure is carried out under local anesthesia with intravenous sedation to assure patient comfort. A small catheter is placed into the vein to perform a diagnostic venogram. Blood supply to the pelvic varices is then blocked by the use of surgical plugs and or embolic agents. The blood is then rerouted from the damaged veins into healthy veins. After the procedure, patients can return home or to work immediately. There is an 85 to 95% success rate in pain reduction following this procedure. To learn more, please contact the IR team at 716.929.9484.