Organization

Field Name

ID

Required

KCR

ALK Rearrangement

34125

yes 

SEER

ALK Rearrangement

3938

yes 

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.

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