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ItemsProposed improvement

Planned Release date

(*this is provisional only and is subject to change)


Browse Content Changes for the January 2020 Release

The daily build is available to review changes made to content for the January 2020 release

Forthcoming concept inactivations, new concepts and changes to existing concepts can be reviewed using the tab 'Daily build.'

January 2020 International Release

Revision of IS A relationships for anatomy concepts 

The new anatomy concept model implemented the enhanced Description Logic features, e.g. reflexive and transitive properties, additional axioms, for consistent logical modeling. The inferred IS A relationships from the OWL anatomy ontology have been reviewed and the changes have been implemented in the production. The potential impact to other hierarchies, such as disorders, procedures, observables, situations etc are also reviewed as part of the project.

The revision of cardiovascular, digestive and genitourinary systems have been included in the July 2019 release. The respiratory, nervous, integumentary, endocrine, immune, sensory organs, lymphoreticular, hematological systems will be revised in the January 2020 International release.

Information about revision of IS_A relationships can be viewed here:

In the July 2019 release changes were made to 113345001|Abdominopelvic structure (body structure)| whilst retaining the ‘synonyms’ of Abdomen and Abdominal structure based on the most common usage.  Further work is currently underway to more explicitly describe and define concepts relating to regional anatomy of the abdomen and pelvis with changes to content due to be implemented after a period of consultation. 

January 2020 International Release

July 2020 International Release


MRCM Changes

Please see:

MRCM changes in the January 2020 release

January 2020 International Release

Quality Initiative

Information about the project can found here - Quality Initiative - Progress

Note: There are changes to the Service Level Agreement for the CRS as a result of the Quality Initiative:

January 2020 International Release

Changes to Case Sensitivity

Over 31,000 descriptions have been reviewed and approximately 5,402 descriptions across 2806 concepts have had their case significance settings corrected as appropriate.   
The changes are across all SNOMED CT hierarchies but in particular disorder concepts (1774), procedure (978) and qualifier values (736). 

The Editorial Guidance on case significance related to descriptions containing numeric values and special characters has been updated for the January 2020 release.

January 2020 International Release

Planned changes to 'Co-occurrent and due to' pattern

During the implementation of the new Description Logic features a conflict was uncovered between the modeling of 'Co-occurrent and due to' and General Concept Inclusions (GCIs). This has resulted in the need to reconsider the modeling of "Co-occurrent and due' and update the Editorial Guide for this area.

There are a number of new concepts in the January 2019 release that are based upon the existing guidance for 'Co-occurrent and due to'. The plan is to update the Editorial Guide and all concepts that are currently modeled as 'Co-occurrent and due to' starting from the July 2019 release.

January 2020 International Release and future releases



Inactivation reason of LIMITED/WAS_A is not allowed for any new content inactivations after the July 2018 release. The WAS_A association refset has not been updated thereafter.

At the Editorial Advisory Group meeting in April 2019, agreement was reached to discontinue the maintenance of WAS_A relationships when inactivating concepts that have a historical association to an inactive concept. When changes are made to a historical relationship for a concept that was previously inactivated using WAS_A, effort will be made to assign a new historical relationship that facilitates traceability of the concept (e.g. DUPLICATE or AMBIGUOUS) as opposed to NON-CONFORMANCE TO EDITORIAL POLICY.

Existing WAS_A relationships will be inactivated in a future release once a plan for batch reassignment of historical relationships has been developed. Until then, SNOMED International will not continue to use or maintain WAS_A relationships.

January 2020 International Release and future releases

Known Content Issues July 2019 Release

Approximately 149 text definitions are missing either a US or GB spelling variation. These are all legacy issues that will be rectified in the January 2020 release.

A small set of disorder concepts have been identified with descendants that have a semantic tag of clinical finding. A further small set of concepts have been identified that have a semantic tag of disorder but are not descendants of 64572001|Disease (disorder)|. These concepts are all legacy issues that will be rectified in the January 2020 release.

Release validation rules have been enhanced to prevent recurrence of legacy issues for future content additions.

January 2020 International Release

Changes for 'On examination' (O/E) and 'Complaining of' (C/O) concepts

Jan 2020 release:

  • Addition of approximately new 230 concepts to cover content identified (to date) as having no base concept.
  • Continued analysis of O/E and C/O content to determine replacement content (current suitable concept, new or no value in replacing)

July 2020 release:

  • Addition of any further required content
  • Inactivation of the O/E and C/O content (Batch change) for return to the UK.

Content being inactivated will use the reason - component moved elsewhere. 

Note: some concepts will not have a replacement concept as they are groupers. For example:
On examination - sign irregular (finding)
On examination - neurological reflex (finding)

January 2020 International Release

July 2020 International Release


Inactivation of 33359002 |Degeneration (morphologic abnormality)|

In order to distinguish the degenerative process from the structure, 33359002 |Degeneration (morphologic abnormality)| has been inactivated as a DUPLICATE, SAME AS 107669003 |Degenerative abnormality (morphologic abnormality)|.

All morphologies in the disorder hierarchy have been replaced accordingly.

107669003 |Degenerative abnormality (morphologic abnormality)|

33359002 |Degeneration (morphologic abnormality)|

January 2020 International Release

Inactivation of 23583003 |Inflammation (morphologic abnormality)

In order to distinguish inflammatory process from structure, 23583003 |Inflammation (morphologic abnormality)| has been Inactivated as DUPLICATE, SAME AS 409774005 |Inflammatory morphology (morphologic abnormality)|.

All concepts in the Inflammatory disorder hierarchy have been remodeled accordingly. 

January 2020 International Release
12ICD-O project work

IACR have released ICD-O-3.2 as a listing of all new additions, changes and revisions to ICD-O-3.1 in Excel format. The new version, ICD-O-3.2, is recommended for use from 2020.  ICD-O-3.2 is not yet available online or in book format. In preparation for the update, the changes have been divided into types and are being investigated/addressed in the ICD-O-3.2 update project. The priority is being given to those that have an impact on clinical safety, e.g., changes of behaviour (benign, malignant etc.) and adding new content for SNOMED CT morphologies, this refers to the 400177003 |Neoplasm and/or hamartoma (morphologic abnormality)| hierarchy.

The descriptions with [obs] have been inactivated as outdated because they are artefacts of descriptions from the ICD-O-3 print version for their history tracking. 

The maps to ICD-O-3.1 are being updated only for error correction purposes for the January 2020 release. The maps to ICD-O-3.2 are out of scope for the January 2020 release and are planned for a future release.

January 2020 International Release

Over the Counter

Concepts referring to “over the counter” status have been inactivated. 

Concepts referring to regulatory status or characterization (e.g. over the counter) are out of scope for the International Release since the meaning may vary by jurisdiction and is not consistent internationally.

January 2020 International Release

Antigens Required for the Vaccine Products

As a Vaccine project work item and based on requests submitted mutually by Argentina and Canada, new antigen concepts (~150) have been added to the Substance hierarchy to be used in the modeling of vaccine products in a future release.

January 2020 International Release

Vaccine Poisoning

Concepts referring to vaccine poisoning have been inactivated from the International release and moved to the NHS extension per their request.

The notion of vaccine poisoning has persisted in ICD 10 under T50 but it is not included in ICD-11; the poisoning aspect seemingly referred to the adjuvants and carriers that are included in the vaccines as opposed to the biological component itself.

January 2020 International Release

Traumatic Dislocation

Traumatic dislocation concepts are being remodeled according to the new representation using DUE TO "Traumatic event".

This work has been partially completed for the Jan 2020 release, resulting in the remaining subhierarchies moving from under "Traumatic dislocation of joint" to "Dislocation of joint". These remaining subhierarchies will be remodeled for the July 2020 release.

January 2020 International Release

July 2020 International Release


Revision of 298180004 |Finding of range of joint movement (finding)

The concepts under the subhierarchy 298180004 |Finding of range of joint movement (finding)| are being remodeled to represent the finding site of <<785818007 |Structure of joint region (body structure)| instead of <<39352004 |Joint structure (body structure)|. 

Range of movement of a joint region can be impacted by both bone and soft tissues, therefore the use of 39352004 |Joint structure (body structure)| was too restrictive and caused issues in other areas of the terminology.  These changes will be made over the course of two releases due to the number of affected concepts.

July 2019 International Release

January 2020 International Release


Planned changes to Implantation and Insertion procedures

Work commenced on content tracker IHTSDO-175 IHTSDO-175 - Getting issue details... STATUS

Ongoing structural changes for the Procedure concepts related to the content tracker:

It was agreed that not all Insertion and Implantation procedures are surgical.

As a result, further work in the hierarchy under 129284003 |Surgical action (qualifier value)| has been undertaken for the January 2020 release and this includes:
Reactivation of 129338005 |Surgical implantation - action (qualifier value)|
Addition of a new concept 788288006 |Surgical reimplantation - action (qualifier value)|
Remodel of 'Reimplantation procedures' replaced METHOD = 129337000 |Reimplantation - action (qualifier value)| with new 788288006 |Surgical reimplantation - action (qualifier value)|.

Work on this project will continue for future releases after January 2020.

January 2020 International Release


Replacement of the Stated Relationship files with the new OWL Axiom refset files

A set of documentations has been developed to support the Logic Profile Enhancements. 

For any questions, please contact SNOMED International at with “OWL Axiom refset files implementation question” in the subject line. 

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  1. Andrew Atkinson - can we re-arrange in Chronological Order?

  2. I see efforts around ICD-11 and ICD-O. Can someone from SNOMED CT comment on whether there are any plans to harmonize SCT with ICHI.

    The overlap of SNOMED CT procedures with ICHI is mind provoking.

    link to existing themes

  3. Hello Vojtech

    We are currently discussing with WHO how we will progress with linking SNOMED CT to the family of classification going forward, with the current focus on ICD-11 since it is released. We hope that the work we are doing on exploring how to more efficiently create a link with ICD-11 is work that can then be reused for the other WHO classifications.

    It would be helpful to understand the approach countries are going to be taking to implementing ICHI along with timelines, so that we can factor that in to our planning. Can you give us some information about this if you have it, or knowledge of any work already going on in this space

    Best wishes

    Jane Millar

    Collaboration Lead


  4. Thanks Jane Millar and Vojtech Huser for raising this message thread.

    Not being very familiar with ICHI myself, and knowing that we use CCI (Canadian Classification of Health Interventions) here in Canada, I reached out to Sharon Baker, the Manager of Classifications at CIHI based on Jane’s request to understand more.  Here is Sharon’s response: 

    Interesting email thread. ICHI is structured with various degrees of specificity for use at the different levels of the health systems, and uses a common accepted terminology in order to permit comparison of data between countries and services. To understand the differences between ICHI and CCI, Classifications and Terminologies have been undertaking mapping projects, as well as participating in field-trials. ICHI contains around 7,500 codes, whereas CCI has >16,000 codes so there definitely less coverage, and in some cases less specificity. However, ICHI covers all parts of the health system, and contains a wide range of new material not found in CCI e.g. Functioning and public health interventions, so we will asses if there is a need to incorporate this additional content into CCI. However, the long term implications of ICHI will require substantial discussion among interested parties in Canada.

    Of note, I am a member of the ICHI Task Force and we have a meeting in September so I can certainly bring this forward as a discussion point.

    If anyone is interested, more information about CCI can be found here: