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An 900000000000480006 |Attribute value type reference set|allows a value from a specified range to be associated with a component. This type of reference set can be used for a range of purposes where there is a requirement to provide additional information about particular concepts, descriptions or relationships. For example, an 900000000000480006 |Attribute value type reference set|is used to indicate the reason why a concept has been inactivated.

Data Structure

An Attribute value reference set is a component reference set used to apply a tagged value to a SNOMED CT component. Its structure is shown in the following table.

Table 5.2.3-5: Attribute Value Reference Set - Data Structure


Data type


Part of Primary Key


A 128 bit unsigned Integer, uniquely identifying this reference set member.

Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.

NOYES (Full /Snapshot)

The inclusive date or time at which this version of the identified reference set member became the current version.

Note: In distribution files the effectiveTime should follow the short ISO date format (YYYYMMDD) and should not include the hours, minutes, seconds or timezone indicator.

The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T .


YES (Full)

Optional (Snapshot) 

The state of the identified reference set member as at the specified effectiveTime .

If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.


Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime .

The value must be a subtype of 900000000000443000 |Module (core metadata concept)|within the metadata hierarchy.


Identifies the reference set to which this reference set member belongs.

In this case, a subtype descendant of: 900000000000480006 |Attribute value type reference set|


A reference to the SNOMED CT component to be included in the reference set.




Depends on specific useNO


The metadata concepts shown in Table 5.2.3-2 are examples of concepts that identify attribute value reference sets.  Table 5.2.3-2 and  Table 5.2.3-3 show the metadata concepts that represent the permitted values for the valueId column in the  |Concept inactivation indicator reference set| and  |Description inactivation indicator reference set|.

Table 5.2.3-2: Attribute Value Reference Sets in the Metadata Hierarchy

   900000000000454005 |Foundation metadata concept|
900000000000455006 |Reference set|
900000000000480006 |Attribute value type|
900000000000489007 |Concept inactivation indicator reference set|
900000000000490003 |Description inactivation indicator reference set|
900000000000547002 |Relationship inactivation indicator reference set|  /*  <-- Not currently used  */
                        /*  Other attribute value reference sets exist but are not used to track component inactivation  */

Item 5.2.3-1: Concept Inactivation Values (with usage notes)

   900000000001043018 |Concept inactivation value|      
723277005 |Nonconformance to editorial policy component|   /*  <-- New value introduced in 2017-07-31 International Release  */
900000000000482003 |Duplicate|
900000000000483008 |Outdated|
900000000000484002 |Ambiguous|
900000000000485001 |Erroneous|
900000000000486000 |Limited|
900000000000487009 |Moved elsewhere|
900000000000492006 |Pending move|      /*  <-- NEVER used for descriptions in the International Release - may have been used in extensions  */

Table 5.2.3-3: Description Inactivation Values (with usage notes)

   900000000001077011 |Description inactivation value|
723277005 |Nonconformance to editorial policy component|   /*  <-- New value introduced in 2017-07-31 International Release  */
723278000 |Not semantically equivalent component|          /*  <-- New value introduced in 2017-07-31 International Release  */
900000000000483008 |Outdated|
900000000000485001 |Erroneous|
900000000000495008 |Concept non-current|
900000000000486000 |Limited|           /*  <-- NOT used for description inactivations after 2010-07-31 International Releases  */
900000000000487009 |Moved elsewhere|   /*  <-- NOT used for description inactivations before 2016-07-31 or after 2017-07-31 International Releases  */
900000000000482003 |Duplicate|         /*  <-- NOT used for description inactivations before 2016-07-31 or after 2017-07-31 International Releases  */
900000000000494007 |Inappropriate|     /*  <-- NOT used for description inactivations before 2008-07-31 or after 2017-07-31 International Releases  */
900000000000492006 |Pending move|      /*  <-- NEVER used for descriptions in the International Release - may have been used in extensions  */

Reference Set Descriptor and Example Data

Notes on the tables used to show descriptors and examples

The reference set example tables on this page have been revised as follows to aid clarity and understanding:

  • The first four columns which are present in all release files are not shown. The omitted columns (ideffectiveTimeactivemoduleId) are used in the same way in all referenced sets to support identification, versioning and packaging. They do not directly affect the specific features of a particular reference set or reference set type.
  • Reference set columns that contain SNOMED CT identifiers are expanded to show details of the concept or description referenced by that identifier. In some cases, the term is shown in the same column using the expression syntax, in other cases an additional column with a name suffix '_term' has been added. In the standard reference set files only the identifier is present in the column and there is no added column for the term. When using reference sets, the term and other details of the component are looked up from the relevant component release files.

Descriptor Template

The tables below show the descriptors that define examples of reference sets that follow the 900000000000480006 |Attribute value type reference set|pattern.

Table 5.2.3-5: Refset Descriptor Rows for the Concept Inactivation Indicator Reference Set

Table 5.2.3-5: Refset Descriptor Rows for the Description Inactivation Indicator Reference Set

Example Data

Example 5.2.3-1: Sample Rows from the Concept Inactivation Indicator Reference Set