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At least one language Reference Set needs to be imported. This is essential to enable the preferred term to be identified for each concept. The language reference sets in the International Release are shown in Table 4.2.1-1.

Table 4.2.1-1: English [International Organization for Standardization 639-1 code en] language reference set (foundation metadata concept) (900000000000507009)

The Language Reference Set hierarchy is extensible and other languages and dialects may be added to the hierarchy shown. These additions may be in the  International Release or an SNOMED CT Extension.

900000000000506000 |Language type reference set (foundation metadata concept)|

  • 900000000000507009 English [International Organization for Standardization 639- 

Figure 4.2.1-1: The Language Reference Set Hierarchy

Each language Reference set refers to each of the Descriptions that is used in that language or dialect and assigns a value for the acceptability of the term associated with that Description when applied to the Concept associated with that Description. The values for acceptability are concept enumerations show in Table 4.2.1-2.

Table 4.2.1-2: Acceptability (foundation metadata concept) (900000000000511003)

Id | Term


The referenced description is the preferred description of it specified description type, for the associated concept, in the language or dialect represented by this language reference set.

The term associated with this description is acceptable for use in the language or dialect represented by the reference set.

Ref Notes
1 All distributed language reference sets should be complete. However, some organizations maintain partial language reference sets that only specify differences from an existing reference set. For example, these reference sets may assume a default to the US English fully specified name. There is no formally specified set of rules for determining the appropriate descriptions from a combination of language reference sets at run time. Therefore, any default rules applied to a particular language reference set should be specified and applied by the organization maintaining that reference set before distribution. [ a b ]