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Once requirements have been identified and submitted as requests for additions or changes, the extension producer need to review and assess these requests. This entails an assessment of whether the requested content is relevant for inclusion in:

  • The
    Gloss
    PreSpacefalse
    tInternational Edition
  • A
    Gloss
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    tNational extension
  • Another extension
  • This extension (i.e. the one being managed by this extension producer)

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Caption table
IdConsiderations relating to appropriateness of content at various levels
Considerations relating to appropriateness of content at various levels


Relevance of requested contentDescription
Within the scope of the International Edition

If the content requested is within the scope of the International Edition, the organization should request that the content should be added to the International Edition.

As SNOMED CT is a global clinical terminology, the scope of the International edition of SNOMED CT is constrained by a set of principles. For inclusion in the International edition, concepts must be

  • Useful in more than one country
  • Necessary for healthcare conformance and interoperability
  • Within the scope of a clinical terminology 
  • Satisfy the criteria of being
    Gloss
    PreSpacefalse
    tunderstandable, reproducible, useful
    GlosTermUnderstandability, Reproducibility and Usefulness

If there is an urgent need for additional content, it may be added to an extension as an interim measure, pending addition to the International Edition. For more information, please refer to Interim content additions below.

Within the scope of other extension, (National, third-party, or local extension) but outside the scope of the International Edition.

The scope of a national edition may permit the addition of content which falls outside the scope of the International Edition but is required within a country, region or territory. If the content requested is within the scope of a national edition, a request should be submitted to the relevant National Release Center.

An organization may also use an extension which was produced by another organization, such as a vendor, regional body or specialist group. In this case, requests for content which fall within the scope of these extensions should be submitted to the relevant extension producer. 

When there is an urgent need for additional content, it may be added to an extension as an interim measure, pending addition to a national edition or externally maintained extension. For more information, please refer to Interim content additions below.

Outside the scope of other extensions, but relevant to the organization requesting the content.

An organization which maintains an extension is responsible for defining the scope of that extension. The scope of an extension should not overlap with the scope of the International Edition or any other extension with modules on which the extension modules depend on. Note that urgent content additions may be permitted as an interim measure, even when the content is within the scope of another edition or extension. For more information. please refer to Interim content additions below.

Requested content which falls within the defined scope of an extension may be added by the organization which maintains the extension. For additional information about adding local content to an extension, please refer to 5.4 Authoring.

Outside the scope of SNOMED CT

The request is rejected

Referential Integrity and Editorial Principles

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Caption ref
Typefigure
IdChange request reporting structure
 illustrates the reporting structure for SNOMED International content requests. In general, only NRCs report to SNOMED International directly. Other extension producers will report to SNOMED International indirectly. However in somes cases, an extension producers may submit change requests directly to SNOMED International. For example, if the extension producer is an Affiliate, based in a non-Member territory.

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IdChange request reporting structure
Change request reporting structure 

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Caption table
IdReasons for requesting content to be added to the International Edition
Reasons for requesting content to be added to the International Edition


Example use caseDescription

Gaps in coverage of scope

Clinical meanings that fall within the scope of the International Edition that are not currently represented by concepts in the International Edition
Changes in clinical knowledgeEvolving clinical knowledge introduces clinical meanings that require the addition of new SNOMED CT concepts
Incomplete definitionsA concept in the International Edition that is missing one or more valid defining relationships
Missing synonymsA concept in the International Edition that is missing one or more widely used synonymous terms

If a request is deemed to have high priority, it should result in action in the next release cycle. However, requests constituting a significant change which impacts other content may take longer to implement. If a request is declined, a reason and explanation are provided to the requester, who may choose to appeal the decision to the Head of Terminology. For more information about the CRS, please refer to the CRS User Guide

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