ALK Rearrangement
Notes
**Note 1:** This SSDI is effective for diagnosis years 2021+ * For cases diagnosed 2018-2020, leave this SSDI blank **Note 2:** Physician statement of ALK rearrangement for non-small cell carcinoma can be used to code this data item when no other information is available. * This data item only includes rearrangements. Ignore any amplification or point mutations **Note 3:** ALK may be recorded for all histologies and stages; however, it is primarily performed for advanced non-small cell carcinomas. If information is not available, code 9. **Note 4:** The absence or presence of ALK protein expression determines if the tumor will respond to treatment with a targeted inhibitor. ALK protein expression predicts the ALK rearrangement gene, which are more likely to respond to the targeted inhibitor treatment. The most common ALK rearrangements are * EML4-ALK * KIF5B-ALK * TFG-ALK * KLC1-ALK **Note 5:** If ALK Rearrangement is positive and there is no mention of the specific rearrangement, code 4. **Note 6:** If neoadjuvant therapy is given, record the assay from tumor specimens prior to neoadjuvant therapy. * If neoadjuvant therapy is given and there are no ALK results from pre-treatment specimens, report the findings from post-treatment specimens **Note 7:** Code 9 when * Insufficient amount of tissue available to perform test * Test done and documented to be equivocal * No microscopic confirmation of tumor * ALK Rearrangement not ordered or not done, or unknown if ordered or done| Code | Description |
|---|---|
| 0 | Normal ALK negative Negative for rearrangement, no rearrangement identified, no mutations (somatic) identified, not present, not detected |
| 1 | Abnormal Rearrangement identified/detected: EML4-ALK, KIF5B-ALK, TFG-ALK, and/or KLC1-ALK |
| 2 | Rearrangement identified/detected: Other ALK Rearrangement not listed in code 1 |
| 4 | Rearrangement, NOS |
| 7 | Test ordered, results not in chart |
| 8 | Not applicable: Information not collected for this case (If this information is required by your standard setter, use of code 8 may result in an edit error.) |
| 9 | Not documented in medical record ALK Rearrangement not assessed or unknown if assessed |
| <BLANK> | N/A - Diagnosis year is prior to 2021 |