Number of Cancer Cases with Prescription Drugs on the Durable Medical Equipment Files

If a patient receives an oral chemotherapeutic agent that is equivalent to a chemotherapy administered intravenously, this agent may be captured in the Durable Medical Equipment (DME) file. Under most circumstances, CMS requires providers to use 11-digit National Drugs Codes (NDCs) when submitting DME claims for oral anti-cancer drugs. For patients in clinical trials, chemotherapeutic agents that would have typically been provided absent a clinical trial (e.g., conventional care) are billed in DME claims using HCPCS J codes. To assist investigators in assessing whether they need DME data for their analyses, frequency tables by brand drug name associated with the NDC codes and by HCPCS J codes have been generated. The first set of tables show the number of patients with each brand drug name by year. The second set of tables show the number of patients with each HCPCS J code by year. Both sets of tables have been produced for all patients in the SEER-Medicare Cancer file and separately for breast, prostate, lung, and colorectal cancer patients. Please note that the SEER file includes SEER-linked cases diagnosed from 1999 to 2019, but only SEER cases diagnosed from 2000 to 2019 from the expansion registries: Greater California, New Jersey, Louisiana, Kentucky, Greater Georgia, Idaho, New York, Massachusetts, and Texas.

Please note that HCPCS WW codes, which are also related to the administration of chemotherapy and may be in the DME file, are not included in the below tables. HCPCS WW codes are used for internal processing only and are to be used only in conjunction with specific NDC codes and thus would only overlap with the NDC information.

MA

Number of Patients with Prescription Drugs in DME file by NDC Brand Name

Number of Patients with Prescription Drugs in DME file by HCPCS J codes

FFS

Number of Patients with Prescription Drugs in DME file by NDC Brand Name

Number of Patients with Prescription Drugs in DME file by HCPCS J codes

Last Updated: 09 May, 2024