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We have received a number of requests for lateralized amputation procedures which are correctly classifying under these ambiguous groupers, but highlight the potential issue with these concepts. Example:
46028000 |Amputation of hand (procedure)|
895522007 |Amputation of left hand (procedure)|
895473002 |Amputation of bilateral hands (procedure)|
895523002 |Amputation of right hand (procedure)|
895473002 |Amputation of bilateral hands (procedure)|
Many of the existing laterality agnostic procedures are long-standing within the terminology, having been extant since the initial 20020131 release.
The questions I have related to the importance of having groupers like this in the age of ECL vs. the patient safety risk of using these in a medical record. Is it more important to have a hierarchical structure vs. a flatter structure that requires more precision in the use of the terminology?
With disorders, this does not seem to be as big an issue, but with procedures, it strikes me as being significant. As SNOMED is meant to be a clinical terminology, i.e. used in contemporaneous recording of data, ambiguous terms in procedures could cause problems.
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