First course treatment--Heme & Lymphoid Neoplasms: Is the use of the corticosteroid, Clobetasol, cancer-directed treatment for mycosis fungoides or is it only used to treat the side effects of that disease?
Clobetasol is not cancer-directed treatment at this time.
Note: Question originally submitted in 2010. During 2014 review, this was checked and Clobetasol is still not cancer directed treatment for Mycosis Fungoides.
First course treatment--Heme & Lymphoid Neoplasms: Why isn't darbepoietin coded as treatment for hematopoietic diseases?
Darbepoietin is a synthetic form of erythropoietin. It stimulates erythropoiesis (increases red blood cell levels) and is used to treat anemia, commonly associated with chronic renal failure and cancer chemotherapy.
Darbepoietin is a support medication; it does not treat cancer. It is used to treat anemia caused by cancer directed chemotherapy treatments. It is not indicated for patients with myeloid cancers; cancers that originate in the bone marrow like leukemia.
Darbopoietin is an ancillary drug and is not coded as treatment.
First course treatment--Leukemia: How should an allogeneic stem cell transplant for acute myeloid leukemia be coded in the Hematologic Transplant and Endocrine Procedures field? See Discussion.
There is debate as to whether this procedure should be coded as a 12 in order to capture the allogeneic part of the procedure.
Assign code 20 [Stem cell harvest (stem cell transplant) and infusion as first course therapy] for stem cell procedures, even allogeneic procedures.
First Course Treatment--Liver: Given that agents can be used that are not chemotherapy drugs, how should treatment be coded for a procedure called a "chemoembolization" when the agent used is not documented?
This issue was discussed among the national standard setters and per the SEER website this issue has been resolved as follows: When "chemoembolization" is done but the agents used are not chemotherapy drugs, then treatment should be coded as "Other Therapy." See http://seer.cancer.gov/tools/codingmanuals/embolization.html
First Course Treatment--Lymphoma: Should the use of proton pump inhibitors be coded as treatment for lymphoma primaries in patients with H Pylori?
No, do not code proton pump inhibitors as treatment. These are used for gastric acid suppression. Proton pump inhibitors are used to treat symptoms, not the lymphoma itself.
First Course Treatment--Melanoma: How and where is the excision for an in-transit metastasis coded if the in-transit metastasis is coded in CS Lymph Nodes? See Discussion.
Excision of skin of scalp nodule reveals in transit metastasis of melanoma. Patient also has lung metastasis and begins systemic treatment. No primary tumor identified.
Code the excision in Surgical Procedure of Other Site because no primary tumor was identified.
First course treatment--Prostate: Is Degarelix coded as hormonal treatment for prostate cancer?
Code the administration of Degarelix in the "Hormone Therapy" field. Assign code 01 [Hormone therapy administered as first course therapy]. This drug will be added to the next update of SEER*Rx.
First Course Treatment--Prostatic Urethra: Is Lupron coded for a papillary carcinoma of the prostatic urethra that is treated with a TUR with fulguration and beam radiation even though the prostate biopsies are negative?
Do not code lupron as treatment for a primary in the prostatic urethra.
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