November 2015 | No. 178
Editors' Corner

Dear NCBC Members:
We are pleased with the November NCBC Newsletter as the Feature Article addresses a critical development for physicians, hospitals, and breast centers ICD-10 Coding. In addition, the Citation-Based Editorial by Rufus Mark, MD, based on an article by Landercasper, et al, on Reoperations is very important to discuss within your breast conference. On the legislative and practical front, we have information for Breast Centers to use when discussing the variety of mammography guidelines which are now complicated even more with the American Cancer Society announcement. 
Feature Article

Ready or Not, ICD-10 is Here
By Melody W. Mulaik, MSHS, CRA, FAHRA, RCC, CPC, CPC-H
Radiology Today
Vol. 16 No. 9 P. 12

The ICD-10 Coding System officially became active on October 1, 2015. The feature article by Melody Mulaik, MSHS, CRA, FAHRA, RCC, CPC, CPC-H, delivers a comprehensive summary (Radiology, 2015; 16[9]:12). Coding accuracy has become increasingly complex and important for reimbursement. ICD-9 included 13,000 diagnostic codes and 3,000 procedure codes. ICD-10, numbers 68,000 diagnostic codes and 87,000 procedure codes. 

Fortunately, there are software programs specifically addressing ICD-10. For Radiation Oncology MOSAIQ and ARIA both address ICD-10, simplifying code entry. Radiology also has such systems, including TriZetto, Scriptor, and Code Ryte. I have been told by colleagues that Medical Oncology uses Oncology-EMR for ICD-10 with no problem. This article is reprinted by permission of Radiology Today. NCBC is very appreciative. Read More....
Editorial: ASBS Consensus Statement on Reoperations
Rufus Mark, MD 

The American Society of Breast Surgeons assembled a multidisciplinary Consensus Conference in 2015 to address the reoperation rates after initial lumpectomy for breast cancer with varying cosmetic results. The current rate of reoperation in the United States ranges from 10-50%, which is not accounted for by patient or tumor characteristics. Landercasper et al, (Annals of Surg Oncol, 2015; 22[10]:3174) reported the results of the Consensus Conference in the form of an eleven point Tool Box described in the Editorial. These issues should be discussed at the breast conference.  Read More....
Conference - Poster Session

You and your breast center team are invited to submit an abstract to the NCoBC's 26th Annual Interdisciplinary Breast Center Conference.  The abstract/poster program provides a great opportunity to share your experience and research with other breast health care professionals. The goals of this session are to facilitate communication between breast care centers, to disseminate knowledge that may be useful to our members, and to give recognition to outstanding submissions. For 2016, a third category (Category III - Breast Cancer Diagnosis and Management) has been added to encourage medical specialists to submit their abstracts.  Read More...
Post Conference Options
The 26th Annual Meeting of NCoBC is scheduled for April 9-13, 2016, at the Paris Hotel in Las Vegas. Like usual we expect an exciting, thought provoking academic meeting spiced with social interaction and lots of fun! Last year, there were many interesting and important abstracts presented. We encourage you to submit an abstract. Guidance on the submission process can be found in this Newsletter. Conference registration information can be found on our website We also encourage attendees to sign-up for one of the post-Conference sessions. Below are three more of our eight post conferences that you can attend. There were three in last month's issue as well.  See all Post Conferences being offered on Tuesday April 12, 2016.

  • Creating a Successful Radioactive Seed Localization Program
Historically, for the past 30 years preoperative needle localization of non-palpable breast lesions has been performed using image-guided wire localization techniques.  While wires have been the standard for decades, clinical issues related to wire placement include wire migration and wire fragmentation, and operationally the operating room schedule is married to the radiology schedule typically performed earlier the same day.  In the United States, pre-operative radioactive seed localization techniques are increasingly being used over the past decade instead of wires, with decoupling of radiology and surgical schedules.  More and more breast centers are interested in implementing an RSL program at their facilities.  In this workshop, a everything a program needs to know to initiate and implement an RSL program will be presented by faculty from one institution.
  • Mammography, Ultrasound and Stereotactic Boot Camp
Breast Imaging professionals will be presented with the most current techniques and advances used in Mammography, Ultrasound & Stereotactic for the detection of breast cancer, including implementation, presentation of proper positioning techniques and the importance of each positioning. Trouble shooting techniques will be presented for Mammography, Ultrasound and Stereotactic. Challenging positioning examples will be explored with ways to address issues to achieve quality images.
  • Pursuing Excellent in Your Navigation Program: Nuts & Bolts for Every Practitioner
Navigators at all levels of care are often tasked with the start-up or crucial updates to their navigation program. Understanding all the main points of creating the highest standards of care are often daunting.  Learning about the different aspects of navigation while providing exceptional care for your current patients can leave a navigator feeling frustrated and unsatisfied. Welcome to the program that will touch on all the main bases of navigation from nationally recognized standards of care, understanding the legalities of the profession, proving the worth of your program, and developing a needs assessment at a community, facility, and patient level. Whether you are at the beginning of your navigation development or deeply immersed in its implementation this program has something valuable for you.  The speakers were specially selected for this course to do more than deliver information; participants can expect a strong educational component, interactive dialog, and a package of crucial steps to move step-by-step to program completion.
Mammography Screening Guidelines

Mammography screening intervals have just become more confusing for women. The recent American Cancer Society's release of new Mammography Screening Guidelines recommend screening later, starting at age 45, and switching to yearly at age 55. This is a departure from the historical guideline of starting mammography at age 40.  To complicate this further, the United States Preventive Services Task Force [USPSTF] recommends that women at average risk start mammograms at age 50. The NCBC recommendation is to continue to start mammography at age 40. Please read the NCBC press release included in the Newsletter.

NCBC Education: Save These Dates

Navigator Certification Exams

April 12 or 13, 2016  ~ Las Vegas, NV 

Clinical Breast Examiner (CBE)

April 12- 13, 2016  ~  Las Vegas, NV

26th Annual Interdisciplinary Breast Center Conference

April 9-13, 2016  ~  Las Vegas, NV

For more Information please call (574) 267-8058
or Visit for details & registration

In summary, this issue has several points of interest. Please share with the breast center team the Feature Article on ICD-10 and the Editorial about the new Consensus Statement on Reoperations. In addition, encourage the breast center team to participate in the 2016 conference and take advantage of all the sessions, posters, and networking with colleagues across the nation.
NCBC wishes all members a wonderful Thanksgiving with family and friends.


NCBC President
Jennifer Gass, MD, FACS
Breast Fellowship Director
Co-Director, Breast Health Center
Chief of Surgery
Women & Infants Hospital, 
Associate Professor of Surgery, and of Gynecology and Obstetrics
Warren Alpert Medical School, Brown University Providence, RI

Rufus Mark, MD
Radiation Oncology of Central Arizona
Banner University Medical Center
Phoenix, AZ

Susan Casella, RN, OCN
Northside Hospital Cancer Institute Atlanta, GA

Editor Emeritus
Claudia Z. Lee, MBA

NCBC  |  (574) 267-8058  |  [email protected]  |

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