3340 Providence Drive | Anchorage, AK 99508

imagingupdatesSpring 2016

�e Imaging Update is a semiannual newsletter for clinicians and sta� seeking the latest news about Providence Imaging Center. For more information, contact Nathan Switzer in Communications and Marketing at (907) 212-6032, or nathan.switzer@providence.org

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Enter our contest for a chance to win some goodies. Be one of three savvy readers to divine what the mystery images depict in our ‘You be the radiologist’ challenge. Details inside...

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update

PROVIDENCE IMAGING CENTER

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Expanded hours for PET-CT o�eredPatients looking for more appointment choices for their PET scan now have them: Providence Imaging Center in Anchorage now o�ers Monday appointments, in addition to the existing Tuesday through Friday schedule. To schedule a patient, simply call (907) 212-2879, or dial toll-free (888) 458-3151 ext. 2879. Located on the popular Providence Alaska Medical Center campus, we are PPO with most major insurance groups, including Aetna.

Breast cancer screening on the go: 3D mammography rolls out this summerConvenience plus the latest technology will meet patients where they work and live. Providence Imaging Center’s mobile mammography program is pleased to roll out a new coach this summer that o�ers 3D mammography, matching technology o�ered in our Anchorage imaging center. 3D mammography �nds 40 percent more invasive cancers than 2D alone, and is appropriate for all women. Funds in excess of $700,000 will �nance the new coach and mammography equipment. �e project is made possible with generous support from the Providence Alaska Foundation and its community donors, including CARRS-Safeway; Providence Cancer Center, and Providence Imaging Center.

Comprehensive breast imaging services recognized in AnchorageProvidence Imaging Center is your one-stop-shop for comprehensive breast imaging. Whether it be a 2D or 3D mammogram, breast ultrasound, MRI of the breast or mobile mammography—the technology lives here, in one place. We are uniquely accredited as the only center in Anchorage nationally recognized by the American College of Radiology

as a “Breast Imaging Center of Excellence” since 2008.

Two dedicated employees reach signi�cant milestonesWe are privileged to call these two people our coworkers. Each has demonstrated a commitment to Providence that bears broadcasting aloud. �ey’ll be recognized by Providence Health & Service Alaska during the 2016 Service Awards on April 17th. �ank you for your service! Shelley Coolidge, RN – nurse: 25 years of service. Amanda Loy, RT (R)(CT) – CT technologist: 20 years of service.

Lyle Downing takes new management roleProvidence Imaging Center welcomes Lyle Downing MHA, RT(R)(MR) as manager. He brings more than 19 years’ experience in healthcare to the position, which includes oversight of clinical and clerical sta�. Lyle joined Providence in 1997 as a radiologic technologist, and soon discovered a passion for MRI. He took to the modality with eagerness, earning the appreciation of Providence radiologists for his technical expertise and rapport with patients and coworkers. In 2004 he assumed the role of MRI supervisor, developing new skills to lead a

department with six employees and two magnets. He stepped in his  current position in August of last year. When not working, Lyle enjoys his family and the perks of living in one of America’s wilderness playgrounds.

New vascular services added in AnchorageOur Anchorage location is delighted to o�er state of the art non-invasive arterial testing. �e new equipment helps diagnose Peripheral Vascular Disease (PVD). PVD refers to diseases of blood vessels outside the heart and brain. It’s o�en a narrowing of vessels that carry blood to the legs and arms. Learn more about the di�erent vascular services we provide today! provimaging.com/services/ultrasound/

Sonographer certi�cationsCongratulations to Laura (le�) and Rachel, sonographers at

Providence Imaging Center: they are o�cially registered in breast ultrasound, a specialized form of sonography used to evaluate

patients who have a clinical breast symptom. Seven sonographers – our entire team – have earned this credential, with a

combination of more than 90 years experience in the �eld!

Meaghan Cerri, CNMT (le�) and Suki Wallis, RT(R)(CT) – Providence Imaging Center's PET-CT technologists.

Anxiety, begone! Anxious patients can be comforted – literally – when they get their next MRI scan. Engineers used insights from the �elds of psychology and aesthetics to build “comfort technology” into Providence Imaging Center’s newest magnet.

According to MRIsafety.com, some investigations indicate that as many as 20% of the individuals attempting to undergo MR procedures can’t complete the exams secondary to serious distress such as claustrophobia or other unwanted sensations.

Providence Imaging Center installed a new wide bore scanner that combats claustrophobia and humanizes the sometimes uncomfortable exam. �e newest and most technologically advanced 1.5 Tesla MRI in the state of Alaska o�ers unparalleled imaging quality in a high �eld magnet, while putting patients’ comfort at the forefront:

• More space: the wide bore magnet, 70 cm wide (around 28 inches), accommodates patients up to 500 lbs. (MRI breast patients have a weight limit of 420 lbs.) �e larger opening feels less restrictive and is illuminated with bright and friendly LED lights.

• Exam times are reduced through fewer coil exchanges (coils surround the anatomy that is being scanned).

• Comfortable variable density padding minimizes pressure points.

Chad Hicks, MRI supervisor, loves hearing how patients bene�t from comfort technology built into the new Optima 450W MRI scanner.in this issue...

(article continues on page 3)

�e newest and most technologically advanced 1.5 Tesla MRI in the state of Alaska...Coronal proton density of the knee.

• Silent scan technology can be turned on, which reduces decibels and allows for better communication with the technologist. Less noise o�en translates to reduced patient anxiety.

30thirty years youngcelebrating

• NEW MRI Technology • Nate’s Notes • Center Updates • Contest Winners!

from le� to right: Carol, Robin, Chad and Stephanie(not pictured: Scott and Amanda)

No medical technology alone can promise to deliver the perfect exam. Many important factors contribute to good quality images and a positive patient experience.

Sometimes a reassuring family member in the room makes the di�erence. In other instances, a medication can be prescribed to relax someone who is anxious.

More New Technology for MRI PatientsOur 3 Tesla scanner – the only magnet of its kind in Anchorage, and twice as strong as most machines in the state – recently underwent a hardware and so�ware upgrade. �ese improvements give specialists the ability to view exceptional images like never before.

Many specialists insist their patients be scanned on a 3 Tesla magnet. Why? Double the �eld strength means double the signal, ensuring better image quality than even the best 1.5 Tesla MRI. MRI with 3 Tesla power provides excellent neurological and musculoskeletal evaluations. Additionally, no other Anchorage imaging center o�ers the following specialty examinations at this �eld strength:

• Prostate screening • Rectal cancer screening• Spectroscopy • Perfusion

Convenient hours and Saturday appointments enable us to get patients in sooner, with results arriving to your o�ce immediately upon the radiologist’s dictation and electronic sign-o�.

Not sure if your patient would bene�t from Providence Imaging Center’s newest MRI technology? Want to learn more? Our technologists and radiologists are delighted to chat with you.

Reach us at:(907) 212-5609 (techs) or (907) 212-3182 (radiologist). Schedulers can be reached at:(907) 212-3146 or (888) 458-3151 toll-free.

do youknow what these are?

Simply e-mail your guesses to: Nathan.Switzer@providence.org, or fax me at (907) 212-5827. Be sure to include your name and mailing address and/or contact phone number. Rules: Open to any member of a healthcare provider’s o�ce, anywhere in Alaska. Deadline for entry is June 1, 2016. �ree winning entries will be randomly drawn, and announced in the next newsletter. Ready – set – interpret!

Sarah Johnson Kerrin Smesrud-Lynn Jeannie Pike

Carolina Anzilotti Caeleigh Prickette Heather Kephart

Contest #7 Winners!

contest #7: “Chicken-in-a-Biscuit” crackers, drum sticks, egg beater

1 2 3

nate’s notes

Logo Coloring Contest Winners

AnnouncedCongratulations to our three prize winners who colored the logo page we published in our last newsletter. I am humbled by your

response, patience, and creative talent. Each winner received an adult coloring book by

Brittney Kau�man, who just released her second adult coloring book—your

rendition of our logo inspired many!

Anxiety, begone! Anxious patients can be comforted – literally – when they get their next MRI scan. Engineers used insights from the �elds of psychology and aesthetics to build “comfort technology” into Providence Imaging Center’s newest magnet.

According to MRIsafety.com, some investigations indicate that as many as 20% of the individuals attempting to undergo MR procedures can’t complete the exams secondary to serious distress such as claustrophobia or other unwanted sensations.

Providence Imaging Center installed a new wide bore scanner that combats claustrophobia and humanizes the sometimes uncomfortable exam. �e newest and most technologically advanced 1.5 Tesla MRI in the state of Alaska o�ers unparalleled imaging quality in a high �eld magnet, while putting patients’ comfort at the forefront:

• More space: the wide bore magnet, 70 cm wide (around 28 inches), accommodates patients up to 500 lbs. (MRI breast patients have a weight limit of 420 lbs.) �e larger opening feels less restrictive and is illuminated with bright and friendly LED lights.

• Exam times are reduced through fewer coil exchanges (coils surround the anatomy that is being scanned).

• Comfortable variable density padding minimizes pressure points.

�e warrior awoke early, to prepare for the day’s battle. He had never faced such a foe before: a monster that snaked 45 miles, dark, twisted. Its intricacies had inspired its own Facebook page, and a lore all its own. �e soldier

wavered, untested, so�, and accustomed to quick success. Would he succeed in staring down a serpent like this?

So, uhh, yes: here’s the news. I’ve joined the ranks of commuters from �e Valley. And that “foe” is the infamous Glenn Highway. So far I’ve “won” more battles than I’ve “lost.” I certainly have a better appreciation for the

thousands of Alaskans who daily make this journey.

�is year we’re delighted to celebrate Providence Imaging Center’s 30th anniversary. We wouldn’t be here without the strong partnership of the referring provider community—you! Our commitment continues to be imaging

excellence, every time. Learn how a wide bore magnet changes the game for anxious patients, and new wheels that will carry 3D breast cancer detection technology around the state this summer.

We’ll all get where we’re going, eventually, if we take our time and enjoy the view.

ICD-10 Code Compliance Update

ICD-10 implementation has gone smoother than expected. It is a testament to the resiliency and adaptability of Alaskan providers, their nurses, assistants and o�ce sta�. But as we begin 2016, the stakes are raised for ICD-10.

Even though we have a year of protection from denials that started back in October, codes with lack of speci�city from October 2016 forward may result in unpaid claims by Medicare, with commercial insurers sure to follow.

National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) o�en require speci�c diagnosis codes. When we receive ICD-10 diagnosis codes on provider orders, the greatest issues we have seen so far are codes that note “unspeci�ed” in the description. �ese are the codes that may result in payment denials.

It is important to remember that ICD-10 requires no greater speci�city than did ICD-9, with the exception of laterality; which previously did not exist in ICD-9 codes (CMS.gov, 2015). Any LCDs and NCDs that have ICD-10 codes for right side, le� side or bilateral do not allow use of an unspeci�ed side (CMS.gov, 2015).

As you navigate your way through 2016 please put extra focus on those codes that mention unspeci�ed in the descriptor. Speak with the patient, reference their chart and remember, be speci�c; it’s the

principal method of ensuring your patient receives the best possible care, without delay.

MRI Improves Diagnosis of Microbleeding a�er Brain InjuryProvidence Imaging Center is delighted to o�er a specialized MRI sequence utilizing SWI (Susceptibility Weighted Imaging). �e technique called SWAN* allows specialists to see brain vasculature in exquisite detail in one quick, easy scan.

�is service is available on Anchorage’s newest3 Tesla magnet at Providence Imaging Center.

MR brain imaging with SWAN allows our neuroradiologists to:• Visualize major vessels and large

vascular structures

• Reproducibly image and accurately delineate small vessels and microbleeds

• Assess iron and calcium deposits in tissue

• Image the whole brain in 3D high resolution in as little as 3-4 minutes

• Make more accurate, more con�dent di�erential diagnoses in patients with hemorrhages, cerebrovascular and ischemic brain diseases, TBIs, arteriovenous malformations, neurodegenerative diseases and a variety of other lesions

Meet our SWAN experts:

• Silent scan technology can be turned on, which reduces decibels and allows for better communication with the technologist. Less noise o�en translates to reduced patient anxiety.

by Lyle Downing MHA,RT (R)(MR)

Manager,Clinical Services

NeuroradiologistBryan Winn, MD

NeuroradiologistGerald York, MD

MRI brain image utilizing the SWAN technique, courtesy

of GE Healthcare.

maximized comfort uncompromised imaging

too close for comfo�...Mary,* the friendly MRI tech with a slight southern drawl, emerged from the double doors, seeking her next patient. “Ms. Smith?”

A middle-aged woman anxiously rose to her feet. A gentleman nearby also stood up, and proceeded to follow them into the imaging center’s hallway. “Ah, good, she has a support partner,” Mary mused.

She knew how intimidating an MRI scan could be, with its strange noises and the newness of it all. Having someone in the scan room could enhance her patient’s comfort. She needed to carefully screen both of them to be sure they were safe to enter the MRI suite.

Once they reached the dressing room, Mary listed o� each question, pausing long enough to ascertain their answers and note them: “Do you utilize hearing aids?” “No.” “Do you have tattoos on your eyelids or elsewhere?” “No.” “Heart pacemaker or de�brillator?” “No” and “No” were the answers given.

Mary noticed that the couple seemed a little troubled, and the woman’s body posture belied some persistent discomfort. She kept giving the man next to her sidelong glances, as if she were upset with how he answered the important screening questions.

“Nothing to do but forge ahead,” Mary determined. She �nished with an explanation of the MRI as essentially a long tube, open at both ends. �ere would be a fair amount of noise, so earplugs were necessary. Lastly, Ms. Smith would need to put on a gown, devoid of any metal snaps or zippers.

�e gown instructions made her patient almost cringe. “She seems really anxious,” Mary divined. She determined to make her as comfortable as possible. Gazing with compassion upon both of them, she asked: “Will you be going in together?”

Ms. Smith could handle it no longer. She shrieked, “But I don’t even know this man!”* Not her real name

* Propriety GE Healthcare acronym which stands for “3D T2-Star Weighted ANgiography”

(article continued from page 1)

No medical technology alone can promise to deliver the perfect exam. Many important factors contribute to good quality images and a positive patient experience.

Sometimes a reassuring family member in the room makes the di�erence. In other instances, a medication can be prescribed to relax someone who is anxious.

More New Technology for MRI PatientsOur 3 Tesla scanner – the only magnet of its kind in Anchorage, and twice as strong as most machines in the state – recently underwent a hardware and so�ware upgrade. �ese improvements give specialists the ability to view exceptional images like never before.

Many specialists insist their patients be scanned on a 3 Tesla magnet. Why? Double the �eld strength means double the signal, ensuring better image quality than even the best 1.5 Tesla MRI. MRI with 3 Tesla power provides excellent neurological and musculoskeletal evaluations. Additionally, no other Anchorage imaging center o�ers the following specialty examinations at this �eld strength:

• Prostate screening • Rectal cancer screening• Spectroscopy • Perfusion

Convenient hours and Saturday appointments enable us to get patients in sooner, with results arriving to your o�ce immediately upon the radiologist’s dictation and electronic sign-o�.

Not sure if your patient would bene�t from Providence Imaging Center’s newest MRI technology? Want to learn more? Our technologists and radiologists are delighted to chat with you.

Reach us at:(907) 212-5609 (techs) or (907) 212-3182 (radiologist). Schedulers can be reached at:(907) 212-3146 or (888) 458-3151 toll-free.

“You Be The Radiologist” Contest #8

1

2

3

ICD-10 Code Compliance Update

ICD-10 implementation has gone smoother than expected. It is a testament to the resiliency and adaptability of Alaskan providers, their nurses, assistants and o�ce sta�. But as we begin 2016, the stakes are raised for ICD-10.

Even though we have a year of protection from denials that started back in October, codes with lack of speci�city from October 2016 forward may result in unpaid claims by Medicare, with commercial insurers sure to follow.

National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) o�en require speci�c diagnosis codes. When we receive ICD-10 diagnosis codes on provider orders, the greatest issues we have seen so far are codes that note “unspeci�ed” in the description. �ese are the codes that may result in payment denials.

It is important to remember that ICD-10 requires no greater speci�city than did ICD-9, with the exception of laterality; which previously did not exist in ICD-9 codes (CMS.gov, 2015). Any LCDs and NCDs that have ICD-10 codes for right side, le� side or bilateral do not allow use of an unspeci�ed side (CMS.gov, 2015).

As you navigate your way through 2016 please put extra focus on those codes that mention unspeci�ed in the descriptor. Speak with the patient, reference their chart and remember, be speci�c; it’s the

principal method of ensuring your patient receives the best possible care, without delay.

• A 70 cm wide bore to add patient space for comfort

• Silent scan that reduces noise and increases patient comfort

• A coil array that offers feet-first imaging for most exam types

• A new 16-channel breast coil that provides high-resolution breast imaging

• MAVRIC technique enables better evaluation around metal joints / prostheses with reduced artifacts

This system also delivers uncompromised imaging capability for the most advanced and demanding exams.

Schedule your patient’s MRI today at Providence Imaging Center (907) 212-3151 or toll-free (888) 458-3151.

�atu�s include: