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SEER Inquiry System - Report
Produced: 03/31/2026 7:10 AM
Question 20260006
Inquiry Details
References:
Heme & Lymph Manual & DB. October 2025, v3.3
Question:
First Course of Therapy--Heme & Lymphoid Neoplasms: How is first course of treatment coded for hematopoietic and lymphoid neoplasm (heme) cases who are put on surveillance for years while asymptomatic and then start chemotherapy or other treatment years later once they become symptomatic? See Discussion.
Discussion:
Patient was diagnosed with smoldering myeloma in October 2021 and put on surveillance. In May 2024, the patient became symptomatic and started chemotherapy.
Is the date of diagnosis in 2021, with date of first treatment with chemotherapy in 2024? Or is active surveillance first course and treatment with chemotherapy as second course in 2024?
Answer:
Code the first course of treatment as active surveillance. Chemotherapy is second course of treatment based on this scenario due to progression.
We will add clarification about this type of scenario to the Heme Manual for the 2027 update.
