Page History

Introduction

Background

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.

SNOMED International 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.

Purpose

This document provides a summarized description of the content changes included in the July 2019 release of SNOMED Clinical Terms^® (SCT) International Release.

It also includes technical notes detailing the known issues which have been identified and agreed to be released. 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.

The SNOMED International Release Notes are available alongside the July 2019 International Edition release.

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.

Audience

The audience includes National Release Centers, WHO-FIC release centers, vendors of electronic health records, terminology developers and managers who wish to have an understanding of changes that have been incorporated into the July 2019 International Edition release.

Content Development Activity

Summary

Continuous quality improvement and enhancement of existing content is an ongoing process by SNOMED International for every release. The July 2019 International Release has seen a continuation of the work driven by contributions from: Kaiser Permanente Convergent Medical Terminology (CMT), Global Medical Device Nomenclature Agency (GMDNA), Orphanet and and other domain specific collaborations as well as requests received via the Content Request System (CRS). Additionally  Additionally quality improvement activities are in progress for new and enhanced content through project driven initiatives which are also summarized below.  Also   Also included as work items for every release are various updates to SNOMED CT derived maps such as ICD-10 and ICD-O and details O and details are also included in these release notes.  Information   Information about editorial decisions may be found in the the SNOMED CT Editorial Guide, mapping guidance for ICD-10 can be found at this link https://confluence.ihtsdotools.org/display/DOCICD10.

Background

In 2015, a proposal was made to inactivate 159083000 |WAS A (attribute)| relationship and stop updating the 900000000000528000|WAS A association reference set (foundation metadata concept)| at the Editorial Advisory Group.

Since these recommendations were approved, a formal proposal for the technical approach to batch updating the terminology was created and a notice of the proposed inactivation sent to the Community of Practice.

The implementation of changes was postponed following feedback on utility for implementation and the potential impact to customers who were still using RF1.

Content Quality Improvement

Anatomy 

New anatomy concepts: 451

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

Clinical finding

Advance Notice 

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 July 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.

New concepts for clinical findings and disorders: 2114

Quality Initiative

The Quality Initiative (QI) project is the implementation of the Quality Strategy. After a successful pilot project for the July 2018 release the next stage has been implemented for the July 2019 release. 

Quality improvement tasks were deployed to improve internal structural consistency and ensure compliance with editorial policy related to the stated modeling of content. Additionally, correction or addition of defining relationships was carried out to accurately reflect current clinical knowledge and ensure the semantic reliability of descriptions associated with a concept.

The following subhierarchies of the Clinical Finding hierarchy were remodelled to the proximal primitive parent resulting in changes to inferred relationships.

• • • Fracture 
    • Bacterial infectious disease
    • Disease caused by parasite
    • Sexually transmitted disease
    • Chronic inflammatory disease
    • Aneurysm
    • Arthritis
    • Open wound
    • Closed wound
    • Bite wound
    • Congenital malformation
    • Protozoan infection
    • Closed wound
    • Viral disease
    • Hernia of abdominal cavity - Structural improvement of subtypes of the concept 52515009 |Hernia of abdominal cavity (disorder)|. Further work will be undertaken in a subsequent release on the combined disorders where gangrene and/or obstruction is present due to a hernia as well as incisional hernias.
      
    • Burn - Inactivation of burn concepts containing "with loss of body part" and "without loss of body part" approximately 161 concepts.
    • Abrasion - As a result of changes made during the QI project, there are now 2 concepts which have the same preferred term. 
      781488002 |Abrasion of foot (finding)
      211402004 |Abrasion of foot (disorder)
      782201009 |Abrasion (finding)|
      399963005 |Abrasion (disorder)|
      These concepts will be addressed as part the QI project for the July 2019 release.

Total count of changes for the QI project:

Changes to Allergy Content

Approximately 2,000 concepts relating to hypersensitivity conditions have been remodeled to conform with new editorial guidance (excluding hypersensitivity reaction):

• • • Hypersensitivity/Allergy/Non-allergic hypersensitivity condition classes defined using General Concept Inclusion (GCI) axioms in order to encompass disorders, dispositions and processes (reactions).
    • Propensity to adverse reaction and Allergic disposition moved from disorders to findings. The concepts were remodeled using the proximal primitive parents with a role group consisting of 719722006 |Has realization (attribute)| with value of allergic process or its subtype. The new convention for descriptions are Hypersensitivity/Allergy/Non-allergic hypersensitivity to X (finding).
    • New Allergic disorder (disorder) hierarchy representing abnormal structures. The allergic disorders are modeled by associated inflammation morphology + allergic process or subtype + finding site X e.g. Allergic rhinitis).
    • The contact hypersensitivity conditions have been remodeled using the new concepts for Immunoglobin E-mediated allergic contact hypersensitivity process (qualifier value) and Non-immunoglobin E-mediated allergic contact hypersensitivity process (qualifier value).
    • New Intolerance to substance (finding) hierarchy created under Propensity to adverse reaction (finding) as a sibling of Hypersensitivity disposition (finding).
    • 414029004 |Disorder of immune function (disorder)| is remodeled and defined by using a pathological process of 769247005 |Abnormal immune process (qualifier value). As a result, it subsumes allergic disorders and allergic reactions.
    • Pseudoallergy condition and Pseudoallergy disposition renamed to Non-allergic hypersensitivity condition (finding) and Non-allergic hypersensitivity disposition (finding) and they have been remodeled following the new concept model.
    • Inactivation of “Allergy to X" concepts where X is a modification of a base substance and replacement with Allergy to the base substance.

As the result of Allergy project requirements, the following top level groupers/Allergen classes in substance hierarchy were inactivated and their children assigned to appropriate structural and/or functional parents :

• • • 414052000 | Drug allergen by structure |
    • 414057006 | Drug pseudoallergen|
    • 414053005 | Drug allergen or pseudoallergen|
    • 414058001 | Drug pseudoallergen by function|

Note: Other top level groupers (as specified in project Allergies-19) will be inactivated in the future releases.

Any maps from SNOMED CT to ICD-10 impacted by this Quality Initiative have been reviewed and updated.

Work commenced on the following Content Projects:

• • • IHTSDO- 393 Diabetes Complications: The Diabetes Project Group has begun its work on reviewing the current SNOMED CT Diabetes Mellitus disorder concepts. The group is small but is truly international and each member is currently seeking to engage with diabetes specialists within their geographical zone in order to ensure international interoperability within this domain.
      
    • IHTSDO-41 Modeling of 'X' in remission - Approximately 170 disorder in remission concepts can now be found in the hierarchy 765205004 | Disorder in remission (disorder) | as well as the hierarchy relating to the underlying disorder.

Other content quality improvements:

Convergent Medical Terminologies (CMT)

New CMT concepts: 702

The majority of these newly authored concepts are in scope for mapping to ICD-10 and from the following domains:

• • • • CMT Ophthalmology - 285
      • CMT Mixed Domains - 410
      • CMT Musculoskeletal - 7

Procedure Hierarchy

New concepts for procedure hierarchy: 215

Collaboration/Harmonization Projects

Orphanet

As a result of collaboration with Orphanet (http://www.orpha.net/consor/cgi-bin/index.php) 306 new SNOMED CT concepts have been created to represent rare diseases in the disorder hierarchy. All of these concepts have been mapped to ICD-10. 

Global Medical Device Nomenclature Agency (GMDNA)

55 new SNOMED CT concepts created and mapped in the Physical object hierarchy to support the GMDN collaboration agreement.

Event

New concepts added: 6

Work completed on the following Content Projects:

• • • • IHTSDO-1071 - Continued inactivation of transport accidents; movement of all vehicle accidents to children of Transport accidents; Fully-defining some when possible and adding additional parents if appropriate.

Record Artifact

New concepts added: 61

54 new concepts added for care plan.

Organism

New organism concepts added: 326

Content quality improvements:

• • • • 268 New concepts (Including 117 Shiga toxin producing E coli concepts) and 12 changes to the existing concepts' descriptions.
      • Inactivation of 21 ambiguous concepts across multiple hierarchies which had included an animal species when referring to an Influenza virus (e.g., Myocarditis caused by avian influenza (disorder), Influenzavirus type A, avian, H5N1 strain (organism)). 6 new concepts were created in this process.
      • Correction of Influenza virus descriptions: Around 350 corrections/changes were made to Influenza virus descriptions over multiple hierarchies (majority in substance hierarchy but also including disorder, procedure and organism hierarchies). Most of the changes consisted of inactivation of the erroneous description and replacement with a new correct description. In addition, two new concepts were added in the organism hierarchy.
      • Application of consistent case sensitivity to organism descriptions containing "Taxon Rank": Change of the case sensitivity setting for 10282 descriptions (over 4964 concepts).
      • Concepts with descriptions that include the word 'unclassified' were inactivated (7 concepts).
      • Duplicate descriptions were identified and corrected for 11 Concepts.
      • Spelling errors were corrected for 29 concepts.
      • Historical associations were corrected for 32 concepts.

Pharmaceutical / biologic product

The following changes will be included in the 2019-July International Release.

, such as disorders, procedures, observables, situations etc are also reviewed as part of the project.

The subject area for revision of IS A relationships will be determined and updated in the following confluence page https://confluence.ihtsdotools.org/display/IAP/Revision+of+IS-A+relationships+for+anatomy (Please note, you may have to register for Confluence user account in order to access this project).

The initial review was completed for over 12,000 hierarchical relationships that are different between the production release and new anatomy model for body structures. For this release, the focus for the Anatomy project is quality improvement for the cardiovascular, digestive and genitourinary systems. Review of the remaining systems is planned for the 2020 January release.

Changes to hierarchical relationships:

• Cardiovascular system: 1363   
• Digestive system: 906
• Genitourinary system: 510

Reviewed potential impact to other hierarchies e.g. disorder, procedure and addressed most issues.

• Cardiovascular system: over 8600 
• Digestive system: over 7200
• Genitourinary system: over 6800

Quality Improvement in the Body Structure Hierarchy

A branch of a specified artery is not subordinate to its origin but has an IS_A relationship to a more regional artery. Any relationships that did not fulfil this rule have been corrected.

A tributary of a specified vein is not subordinate to the vein it drains in to, but has an IS_A relationship to a regional vein that covers the entire anatomical boundaries of every tributary of that vein. Any relationships that did not fulfil this rule have been corrected.

The vascular structure of an organ is composed of vessels that lie within and are part of the organ and the vessels that lie outside which supply it. So the kidney has glomerular arterioles within the kidney and a renal artery and renal vein that supply and drain the kidney. These relationships have been implemented for most organs and the remaining organs e.g. liver, stomach will be rationalized in the subsequent release.

Distinction has been made between the abdominopelvic structure and its constituent components: structures of the abdomen proper and those subsumed by pelvic structure. In general clinical concepts using the word ‘abdominal’ usually mean ‘abdominopelvic’ but in some specific circumstances a distinction is required; for example the uterus is located in the true pelvis (pelvis major) and not within the abdomen proper.

Skin appendage structures have been placed under skin structure.

Revision made to digital nerves of toe and its subconcepts.

Updates to free margin of eyelid and its subconcepts.

New additions of lumen concepts for the gastrointestinal tract and joint region concepts to support work for the Quality Initiative.

Updated content for the internal part of the mouth region.

Revision of subconcepts of lateral half of face.

Updated and validated release file for the lateralizable body structure reference set.

Updated and validated release files for the SEP refsets.

Clinical finding

New concepts for clinical findings and disorders: 1206 

New content additions include:

• Abnormal uterine bleeding = 8 new concepts
• Abscess = 17 new concepts
• Aneurysm = 12 new concepts
• Benign neoplasm = 22 concepts
• Closed fracture = 47 concepts
• Contracture = 14 concepts
• Open fracture = 15 new concepts

Quality Initiative

The Quality Initiative (QI) project is the implementation of the Quality Strategy. After a successful pilot project for the July 2018 release the next stage has been implemented for the January 2019 and July 2019 release. 

Quality improvement tasks were deployed to improve internal structural consistency and ensure compliance with editorial policy related to the stated modeling of content. Additionally, correction or addition of defining relationships was carried out to accurately reflect current clinical knowledge and ensure the semantic reliability of descriptions associated with a concept.

Total count of changes for the QI project: 

• Stated: A total of 25508 concepts had changes made to the Stated relationships in their models. 
• Inferred: A total of 14887 concepts affected by inferred changes.

As noted in the January 2019 release notes, as a result of changes made during the QI project, there were 2 concepts which had the same preferred term:

• 781488002 |Abrasion of foot (finding) and  211402004 |Abrasion of foot (disorder)
• 782201009 |Abrasion (finding)| and 399963005 |Abrasion (disorder)|

This has been rectified as part the QI project for the July 2019 release.

A bulk operation has been run against 17308 concepts in the << 64572001 |Disease (disorder)| hierarchy which has copied any inferred attributes into the stated view where they did not already exist.  In addition where the Proximal Primitive Parent could be correctly calculated to be 64572001 |Disease (disorder)| the existing immediate fully defined parents have been inactivated and replaced with Disease. This process brings these concepts into line with SNOMED International's Editorial Policy of using a Proximal Primitive Parent where all appropriate attributes are stated and classification ensures that the correct parents are assigned in the inferred view. This is considered to be an efficient authoring style as the hierarchy is maintained mostly automatically by the classifier, rather than requiring authors to manually curate parent child relationships within hierarchies.

Content Tracker Project Updates

Work continues on the following Content Project:

• IHTSDO- 393 Diabetes Complications: The Diabetes Project Group has begun its work on reviewing the current SNOMED CT Diabetes Mellitus disorder concepts. The group is small but is truly international and each member is currently seeking to engage with diabetes specialists within their geographical zone in order to ensure international interoperability within this domain.

Work completed on the following Content Projects:

• IHTSDO-963 Review hierarchy 84229001|Fatigue (finding) and subtypes.
• IHTSDO-1057 Review hierarchy for 276206000|Superficial mycosis (disorder)|.
• IHTSDO-540 The intended meaning of Fracture of <spinal structure> with cord <lesion>.
• IHTSDO-991 Review of puncture and penetrating wound relationship.
• IHTSDO-471 Review concept model: Acne.
• IHTSDO-244 Review hierarchy: 362998000|Branchial cleft anomaly (disorder)

Other Areas of Quality Improvement in the Clinical Finding Hierarchy

Revision of 7890003 |Contracture of joint (disorder)| - Contracture of joint and its subtypes have been remodeled to more precisely represent the anatomical structures associated with contracture.  Joint contractures are due to abnormal shortening of the soft tissues surrounding a joint as opposed to an abnormal morphology of the bony structure of a joint, so the finding site has been changed to "Structure of X joint region". This has resulted in the removal of the previously inferred parent of "Arthropathy" and replaced by "Disorder of joint region" and "Finding of joint movement".

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.

Revision of Schwannoma - All concepts with FSN containing "neurolemmoma" have been replaced with Schwannoma with neurolemmoma retained as a description. 189948006 |Schwannoma (disorder)| has been made active and modeled with associated morphology 985004 |Schwannoma (morphologic abnormality)|.

Revision of Peritoneal eosinophilia - remodel of this area of content including addition of new content.

Fracture - Inactivation of 12 erroneous fracture disorder concepts referencing spinal cord lesions (or cauda equina lesions) of sacrum and/or coccyx where these structures do not exist.

Laboratory clinical finding - Inactivation of two ambiguous laboratory finding concepts and creation of two new replacement concepts.

80093006 |Enophthalmos (disorder)| and subtypes have been remodeled.

Revision of descriptions for dietary concepts - content review identified 76 concepts where the definition had been marked as a synonym, these descriptions have been modified from synonym to definition.  

Revision of description for Caregiver vs. Carer - Descriptions for 109 concepts were modified to align with this pattern: FSN 'caregiver', preferred term 'caregiver', synonym 'carer'.

Review of the hierarchy with parent concept of 432119003 | Aneurysm (disorder). It was noted that there were 4 potential ways of expressing the presence of an aneurysm:

• Aneurysm of xxx artery
• Unruptured aneurysm of xxx artery
• Non-ruptured aneurysm of xxx artery
• Nonruptured aneurysm of xxx artery

The number of concepts using either unruptured, non-ruptured or nonruptured were 13/1/4 respectively. There are 97 'Aneurysm of xxx artery' concepts. A decision was taken to inactivate those concepts of the form 'unruptured/non-ruptured/nonruptured aneurysm of xxx artery' as duplicates and point to their 'aneurysm of xxx artery' equivalents where available and to create new concepts where they were not.

Inactivations were made to remove many classification-derived concepts in the disorder hierarchy concerning late effect or sequela of injuries.  The naming was updated to comply with current editorial advice.  Relationships were added when possible to improve the definition of the concepts. Concepts from the injuries subhierarchy were remodeled when applicable when associated with the sequela/late effect counterpart.  Revisions will continue for the January 2020 release.

Review of medical eponyms with Nazi affiliations. Removed references to "Wegener's" and "Reiter's" from FSNs to support a request to minimize the use of medical eponyms with Nazi affiliations. The terms were retained as synonyms for searching. From the article: "Eponyms and the Nazi Era- Time to Remember and Time for Change."

As part of the removal of Nazi-related names, reactive arthritis was reviewed. 

• Reactivated reactive arthritis, and modeled as a primitive, with a parent of 724606001 |Peripheral spondyloarthritis (disorder)| and due to infectious disease.
• Removed synonym of reactive arthritis from 239783001 |Post-infective arthritis (disorder)|.

Convergent Medical Terminologies (CMT)

New CMT concepts: 702

The majority of these newly authored concepts are in scope for mapping to ICD-10 and from the following domains:

• CMT Ophthalmology: 285
• CMT Mixed Domains: 410
• CMT Musculoskeletal: 7

Procedure

New concepts for procedure hierarchy: 215

Diagnostic imaging - 72 requests were received for new imaging procedure concepts with various imaging modalities.

• Plain X-ray: 63 new concepts
• Magnetic resonance imaging: 3 new concepts
• Ultrasound: 5 new concepts.
• Computed tomography: 1 new concept

Addition of 11 new concepts for laparoscopic procedures including 6 laparascopic pectopexy concepts.

Content Tracker Project Updates

Work completed on the following Content Projects:

• IHTSDO-1004 Review of skin grafting (procedure) hierarchy
• IHTSDO-673 Add concepts: Excisions of dermoid cysts

Other Areas of Quality Improvement in the Procedure Hierarchy

Colorectal excision -changes have been made in either modeling, description, or addition of over ten procedure hierarchy concepts concerning the excision/resection of colon and/or rectum, anal anastomosis, colostomy, and/or creation of intestinal pouch.  

Evaluation procedure changes:

• Inactivations: 9 concepts
  • Inactivated 5 duplicate evaluation procedure concepts
  • Inactivated 2 ambiguous evaluation procedure concepts
  • Inactivated 1 erroneous procedure concept
  • Inactivated 1 non-human evaluation procedure concept and moved to veterinary extension
• Descriptions changes:
  • Improved FSNs of 3 evaluation procedure concepts
  • Updated descriptions on 2 evaluation procedure concepts

121278003 |Drug measurement (procedure)| has been inactivated for the July 2019  Release and descendant concepts have been updated accordingly (n≈150). Because exposure to the substance being measured may or may not be due to the substance being used in a medicinal product, the grouper was inactivated as Ambiguous with Possibly equivalent to relationship to 430925007 |Measurement of substance (procedure)|.

80 descendants of 784396007 |Graft of skin to skin (procedure)| were remodelled to fix issues identified in the previous 304040003|Skin grafting| sub-hierarchy. A consistent modeling plan with one role group was adopted and the FSN and PT terming pattern adapted to match "[skin graft material substance] to [skin structure]." Skin graft procedure concepts were updated and now use the same terming throughout. Subsumptions that were expected but previously did not exist have been achieved through the development of a sub-hierarchy 420934007 Graft of skin (substance) and 32 descendants specifically for use in these procedures. A Template is currently under development.

Created new and remodelled - Implantation and Insertion qualifier values and procedures:

• Inactivated: 71861002 |Implantation (procedure)| - replaced with new 782902008 |Implantation procedure (procedure)|; Retained as subtype of introduction for use with non-biological devices.
• Created new concept: 770651008 |Insertion procedure (procedure)|.
• Reactivated 129336009 |Implantation - action (qualifier value)| as subtype of 424832003 |Surgical introduction - action (qualifier value).
• Made 129337000 |Re-implantation - action (qualifier value)| a subtype.
• Made 129407005 |Grafting - action (qualifier value)| a subtype.
• Made 129406001 |Transplantation - action (qualifier value)| a subtype.

Collaboration/Harmonization Projects

Orphanet

As a result of collaboration with Orphanet (http://www.orpha.net/consor/cgi-bin/index.php), 306 new SNOMED CT concepts have been created to represent rare diseases in the disorder hierarchy. All of these concepts have been mapped to ICD-10. 

Global Medical Device Nomenclature Agency (GMDNA)

31 new SNOMED CT concepts created and mapped in the Physical object hierarchy to support the GMDN collaboration agreement.

Event

New concepts added: 6

Areas of Quality Improvement in the Event Hierarchy

Sexual assault (event) - Definitions were added to some of the sexual assault concepts within the event hierarchy. Forcible sexual assault is sexual assault that involves force, threat of force, or injury. A new concept was added to distinguish sexual assault described as incapacitated when the victim is unable to give consent due to incapacitation. |Sexual assault and rape| was inactivated.

Spelling modified to correct error on 102412001 |Noise polution (event)|.

Content Tracker Project Update

Work completed on the following Content Project:

• IHTSDO-1071 - Inactivation of transport accidents; movement of all vehicle accidents to children of Transport accidents; Fully-defining some when possible and adding additional parents if appropriate.

Qualifier Value

New concepts added: 149

Areas of Quality Improvement in the Qualifier Value Hierarchy

Agencies and organizations (qualifier value) and subtypes moved to National extension 66 concepts inactivated.

Organism

New organism concepts added: 141

Areas of Quality Improvement in the Organism Hierarchy

• Changes made to the organism hierarchy as result of member requests:
  • Added 141 new organism concepts.
  • Updated FSN (and parent) for 266 concepts resulting from taxonomic names changes.

Clarification, simplification and correction of the top levels of the SNOMED CT Organism hierarchy to enhance accurate retrieval and aggregation of organism classes important for defining infectious disease and for laboratory findings for infectious disease:

• Upper levels of the organism hierarchy above the following three (they are at the level of "Organism" and the Domains Prokaryota and Eukaryota).
• Upper levels of the Kingdom Bacteria hierarchy.
• Upper levels of the Virus hierarchy.
• Upper levels of the Kingdom Fungi.

Content Tracker Project Update

Work completed on the following content project:

• IHTSDO-1003 Clarification, simplification and correction of the top levels of the SNOMED CT Organism hierarchy.

Pharmaceutical / biologic product

Veterinary Extension

11 concepts were moved to the Veterinary Extension. 

Social Context

Inactivation of 186005001|Other ethnic non-mixed (NMO)| and children total of 44 concepts.

Situation with Explicit Context

New concepts added : 86

Demo release

• Demo release distributed in 2018-Sep included the following for Medicinal product hierarchy:

  • Updated terming per Ed Guide for existing concepts
  • MP-only (near complete set of concepts to be included in 2019-Jan Release)
  • MPF-only (near complete set of concepts to be included in 2019-Jan Release)
  • Role (subset of content to be included in 2019-Jan Release)

 Veterinary Extension

Situation with Explicit Context

New concepts added : 50

32 new concepts were added for 'X disease suspected.'

Additions and improvements in areas of suspected/risk of bullying, abuse, and abandonment in situation hierarchy.

22 situation concept FSNs updated in areas of organism examination and samples sent.

Content development activity summary

The map is a directed set of relationships from SNOMED CT source concepts to ICD-10 target classification codes.  The SNOMED CT source domains for the MAP are limited to subtypes of 404684003 |clinical finding|, 272379006 |event| and 243796009 |situation with explicit context|.  The target classification codes are ICD-10 2016 release. As part of the ongoing quality improvement of the published maps  SNOMED CT concepts mapped to code range Q90 - Q99 Chromosomal abnormalities, not elsewhere classified  have been reviewed and the previously assigned map advice POSSIBLE REQUIREMENT FOR AN EXTERNAL CAUSE CODE has been removed for consistency purposes. 

 Mapped content for July 2019

The map provided for the July 2019  release has been updated, and now represents a complete map from SNOMED CT International release to ICD-10 2016 version.

2321
• 1319 new concepts added

We would welcome feedback on any issues that users of the map may detect when using the map. Issues should be submitted via mapping@snomed.org

Technical Guide Exemplars

The Technical Guide Exemplars document has now been moved from the International Edition release package to a Confluence page.  This page can be found as part of the ICD-10 Mapping Technical Guide (see Appendix B), which is hosted here:  http://snomed.org/icd10map

ICD-O Map

       There are 5 There are 31 updates for the ICD-O Morphological abnormality map in July 2019 release. 

SNOMED CT to OWL conversion and classification

The repository containing the toolkit enabling simple SNOMED CT to OWL conversion and classification can be found here, including documentation on its use:

 https://github.com/IHTSDO/snomed-owl-toolkit

Please contact SNOMED International at support@snomed.org if you would like to provide any feedback on ways to extend and improve the new toolkit.