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© 2018 International Health Terminology Standards Development Organisation.  All rights reserved.  SNOMED CT® was originally created by the College of American Pathologists.

This document forms part of the SNOMED CT® Denmark Extension release distributed by International Health Terminology Standards Development Organisation, trading as SNOMED International, and is subject to the SNOMED CT® Affiliate License, details of which may be found at 

No part of this document may be reproduced or transmitted in any form or by any means, or stored in any kind of retrieval system, except by an Affiliate of SNOMED International in accordance with the SNOMED CT® Affiliate License. Any modification of this document (including without limitation the removal or modification of this notice) is prohibited without the express written permission of SNOMED International.

Any copy of this document that is not obtained directly from SNOMED International [or a Member of SNOMED International] is not controlled by SNOMED International, and may have been modified and may be out of date. Any recipient of this document who has received it by other means is encouraged to obtain a copy directly from SNOMED International [or a Member of SNOMED International. Details of the Members of SNOMED International may be found at].






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Page At A Glance

1 Introduction

SNOMED CT terminology provides a common language that enables a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.

The International Health Terminology Standards Development organisation (IHTSDO®) maintains the SNOMED CT technical design, the content architecture, the SNOMED CT content (includes the concepts table, the descriptions table, the relationships table, a history table, and ICD mappings), and related technical documentation.


2 Background

This document provides a summarized description of the content changes included in the November 2016 release of the SNOMED Clinical Terms® Managed Service Denmark Extension package.

It will also includes technical notes detailing the known issues which have been identified (should any of these exist). These are content or technical issues where the root cause is understood, and the fix has been discussed and agreed, but has yet to be implemented.

This Denmark Extension package is dependent upon, and should therefore be consumed in conjunction with the SNOMED CT® July 2016 International Edition release.


2.1 Scope

This document is written for the purpose described above and is not intended to provide details of the technical specifications for SNOMED CT or encompass every change made during the release.

3 Content Development Activity

3.1 Summary

This editing cycle was spent transitioning to the July 2016 International Edition baseline, and therefore no new content was created.

3.2 New and Updated Content

This section will be updated from the next Release onwards.


4 Technical notes

4.1 Known Issues

Known Issues are content or technical issues where the root cause is understood, and the resolution has been discussed and agreed but has yet to be implemented.  This can be due to a number of reasons, from lack of capacity within the current editing cycle, to the risk of impact to the stability of SNOMED CT if the fix were to be deployed at that stage in the Product lifecycle.  

For the SNOMED CT Managed Service - Denmark Extension November 2016, the following Known Issues were identified, and agreed to be resolved in the next editing cycle:

Key Summary Description P

4.2 Technical notes

PLEASE NOTE: The June 2016 Denmark Extension, based on the January 2016 International Edition, was not officially published due to this being used as a transition release to support the migration to new tooling.  For completeness we have included the June 2016 release package in MLDS alongside this release of the November 2016 Denmark Extension.

This means that

    1. the Delta files in the June 2016 Denmark Extension package are relative to the February 2016 Denmark Extension package, and 
    2. the Delta files in the November 2016 Denmark Extension package are relative to the June 2016 Denmark Extension package.

Therefore, if you are using Delta files to prime your systems, you should load both the June and November Delta files (in that order), in order to include all content changes since the February 2016 Denmark Extension package.


As described in the June 2016 Denmark Extension release notes, the following changes were made to the ModuleDependency and RefsetDescriptor files in order to correct them:

The refsetDescriptor files were found to be inaccurate in previous packages, and so in this release we have removed the old records and reset the files, as follows:

  • Historical data in the Full file rebuilt from previous release packages.
  • All effectiveTimes updated to this release's effectiveTime, in order to clearly delineate between the erroneous history in the previous packages, and the corrected history in this one.
  • Duplicate UUID's updated to enforce uniqueness.
  • All records that were describing the redundant refsets (and whose files have now been removed from the release package) have now been removed from the refsetDescriptor file.
  • All records that were describing refsets in the International edition (for example the EN-GB and EN-US language refsets) removed as these records already exist in the dependent International edition packages.

The moduleDependency files were corrected as follows:

  • Historical data in the Full file rebuilt from previous release packages.
  • Additional records added in order to call out the dependency of the Danish module (554471000005108) on the Model Component module (900000000000012004) as well as the Core module (900000000000207008). The additional records have been assigned the original effectiveTimes (as if these records had always existed) in order to ensure that the historical audit trail is corrected, so that anyone wishing to use the file for previous releases is able to do so accurately.
  • UUID's corrected to use the original UUID consistently throughout the history (as opposed to having a new UUID for each release) - as this file describes a new state of the same component for each release, and not an actual new component.
  • Dependency of the original 20131018 Danish release corrected to show the dependency on the 20130731 International edition, instead of a circular reference to itself. 






Final Version






Terance ShirdSigned off via Skype


Rory DavidsonSigned off via Skype


Palle PetersenImplicit sign off after no response





Download .pdf here:






Draft Amendment History








Andrew AtkinsonInitial draft created
0.211/11/2016Terance ShirdUpdated with new information, plus invited Palle from the Danish NRC to provide input into the Release Notes - none received so far.
1.017/11/2016Andrew AtkinsonAll necessary updates added, including explanation of why we're releasing 2 packages at the same time, and how people should implement them.


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