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SEER Inquiry System - Report
Produced: 11/25/2025 8:52 PM
Question 20250023
Inquiry Details
References:
#1: 2025 SEER Manual, 225. Hormone Therapy
#2: SEER*Rx
Question:
First Course Treatment/Hormone Therapy--Multiple Myeloma: How is dexamethasone coded when given for multiple myeloma? See Discussion.
Discussion:
The treatment regimen consisting of carfilzomib, lenalidomide, and dexamethasone (KRd) in SEER*Rx says not to code dexamethasone. I have a patient with multiple myeloma who received the KRd protocol in 2018 and the treatment regimen consisting of carfilzomib, daratumumab, and dexamethasone (KdD) (not in SEER Rx) in 2025. SEER RX says to code dexamethasone when it is given for multiple myeloma but also not to code dexamethasone when given as part of the KRd regimen (which is for multiple myeloma). I can follow the KRd instructions if that is what should take priority, but then would I code dexamethasone for the KdD regimen? KdD is not in SEER*Rx and it seems counterintuitive to code it for KdD and not for KRd.
Answer:
Code dexamethasone in KRd regimen (and any other regimen for multiple myeloma containing dexamethasone) as hormonal therapy. Please note that majority of the regimens for multiple myeloma are not in SEER*Rx currently.
The SEER*Rx entry for KRd regimen was updated to indicate that dexamethasone should be coded. The change was done to correct the contradiction with the SEER manual which states, "Code the hormonal agent given as part of combination chemotherapy (e.g., R-CHOP), whether it affects the cancer cells or not" and the SEER*Rx entry for dexamethasone which directs to code it for multiple myeloma.
