SNOMED on FHIR

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Source

SNOMED CT is used in FHIR international standards and resources. SNOMED CT is owned, maintained and distributed by SNOMED International . SNOMED International is the organization which publishes the International Edition of SNOMED CT. SNOMED International Members may also distribute their own SNOMED CT National Edition, which contains the international release plus local extension content and derivatives.

System
The URI http://snomed.info/sct  identifies the SNOMED CT code system.
Version

Where a code system version is used, it should be specified as a URI that represents a specific SNOMED CT Edition published on a particular date (e.g. the International Edition or a National Edition, with a version date), following the SNOMED CT URI Specification  (see note below)

Code

The following SNOMED CT artifacts are valid in the code element for the http://snomed.info/sct namespace: Concept IDs  and Expressions  (grammar ).
SNOMED CT Terms and Description Ids are not valid as codes in FHIR. Nor , nor are other alternative identifiers associated with SNOMED CT Concepts. Expressions SHOULD NOT contain terms. They should only contain concept IDs and other syntax required by the grammar.

Note: when SNOMED CT terms must be exchanged, use the Description Id Extension.

Display

The correct display for a SNOMED CT concept is one of the synonyms for that concept. The best display is the preferred term in the relevant language reference set (if applicable). Preferred terms may be case sensitive. The Fully Specified Name is not an appropriate choice for the display. The preferred term for each concept in a given language or dialect is specified in a Language Reference Set. SNOMED CT does not define displays for expressions. If no display has been associated with the expression through a value set or other mechanism, the full expression with preferred terms embedded may be used (using the standard syntax).

InactiveInactive codes are identified using the 'inactive' property (see below).
SubsumptionSNOMED CT Subsumption testing for concepts is based on the |is a| relationship defined by SNOMED CT.
Filter PropertiesSeveral filter properties are defined, as described below.

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where [sctid] is the concept id that identifies the given SNOMED CT edition (based on the identifier of the most dependent module), and "YYYYMMDD" is the date of release. Examples of sctids that identfy a specific edition are shown in the table below:

SNOMED CT EditionsctidModule SctId
International edition900000000000207008
Australian edition (with drug extension)

32506021000036107

Canadian English edition20621000087109
Canadian French edition

20611000087101

Canadian Refset edition22091000087100
Danish edition554471000005108
Dutch edition11000146104
Spanish edition449081005
Swedish edition45991000052106
UK clinical edition999000021000000109
UK edition (with drug extension)999000031000000106
Uruguay5631000179106
US edition731000124108
US edition (with ICD-10-CM maps)5991000124107

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Simple Map Reference Sets  (reference sets which are descendants of 900000000000496009 "Simple map") also define an implicit concept map. 


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List of Substantive Changes to the above to discuss with HL7

Expressions

We've added a new section for Expressions.   Bringing other text on the page into line with SNOMED International's definition of what constitutes valid SNOMED CT compositional grammer, we've removed advice about including or not including text definitions - both are considered equally valid, although there may be an argument for including the orginal text selected by the end user.