Blog from August, 2023

The proposed changes are detailed in the attached briefing note, and relate to radiographic imaging

Implementation of the content changes specified in this informational briefing note will commence in Q4 2023.

The changes have been based on feedback recieved.

SNOMED International in collaboration with the The International League Against Epilepsy is working on improving the seizure and epilepsy content within the sub hierarchies of

313287004 |Seizure related finding (finding)| and 84757009 |Epilepsy (disorder)|.

To assist content users briefing notes are being provided as changes to content are released. Briefing notes on previous changes may be viewed here.

The content changes for the September 2023 release were made in the area of focal anatomical seizures.

The focal seizure content changes include:

  • Eight new concepts e.g. 1287672003 |Frontal lobe epileptic seizure (finding)|


  • Inactivation of four outdated concepts - list provided as an appendix

Any questions on this work should be sent to with the subject ‘Epilepsy Consultation’.

Kind regards


To update the SNOMED CT community on the replacement of the use of 363703001 |Has intent (attribute)| and value of Therapeutic intent in procedure concepts with a 260686004 |Method

(attribute)| value of Therapy - action, where appropriate. The potential number of affected concepts is nearly 2000.

This briefing note is a continuation of work communicated by a December 2021 briefing note titled, ‘Inactivation of procedures stating intent as diagnostic or therapeutic’.

The Has intent attribute is used when a procedure may be performed for reasons, described with subtypes of 363675004 |Intents (nature of procedure values) (qualifier value)|, such as diagnostic, palliative, preventive, therapeutic, etc. These intents are not used to define procedures with intents that are inherent to the procedure; such as biopsies that are by definition diagnostic, or fracture fixations which are always therapeutic.

Procedures with the Has intent (attribute) with value of Therapeutic intent are classified under 277132007 |Therapeutic procedure (procedure)|. The challenge with |Therapeutic procedure (procedure)| is that it is used to mean: (1) therapy as a medical treatment procedure, or (2) as an intent to differentiate between the same procedure that could possibly have other intents. 277132007 |Therapeutic procedure (procedure) is no longer necessary

Kind regards


The representation of ethnicity and race varies from country to country. For example:

There is no international categorisation that can be used for international content. Given this, ethnicity and racial group concepts are out of scope for the international edition. Next Steps The subtypes of 372148003 |Ethnic group (ethnic group)| and 415229000 |Racial group (racial group)| will be inactivated using the reason Non-conformance to editorial policy with no replacement value. Concepts relevant for use within a specific country may be reactivated within their extension.

The concepts 372148003 |Ethnic group (ethnic group)| and 415229000 |Racial group (racial group)| will remain active.

Comments should be submitted to Cathy Richardson ( or by 21 September 2023.

As part of the QI project, transplantation procedures are being remodeled. To fix incorrect subsumptions changes need to be made. At present surgical transplantation procedures are classifying as subtypes of grafting procedures due to the placement of 410820007 |Surgical transplantation - action (qualifier value)| as a subtype of 129407005 |Grafting - action (qualifier value)|. Example in current SNOMED CT: 32413006 |Transplantation of heart (procedure)| is a 129212008 |Grafting procedure of heart (procedure).

Grafting is generally applied to the application of various types of tissue without their original blood supply, and then that tissue generates its own blood supply from the recipient site.

The attached note provides further detail to the proposed changes.

Comments to be submitted to Nicki Ingram ( or by 15th September 2023.

Kind regards


The attached briefing note summaries the proposed resolution to the Observable entity and Evaluation procedure hierarchies. They were created in the early 2000s and have been maintained as separate hierarchies even though the content is overlapping in many areas. This has created confusion and inconsistency in how observation information is represented in record systems and in SNOMED CT. While some stakeholders have expressed their requirement for separate codes for ordering (evaluation procedure) and resulting (observable entity) observations, other stakeholders have expressed their requirement to include codes for ordering and resulting observations in the same hierarchy at various levels of granularity.

Previous efforts to resolve the issue and meet stakeholder needs have stalled. Details are provided in the attached briefing note.20230809 BN Evaluation procedure to Observable entity v1.0.pdf

Feedback can be submitted via the Chief Termonologist ( by September 15, 2023.

Kind regards

Ian Green