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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 are other alternative identifiers associated with SNOMED CT Concepts.

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).

Note that Display is to display the published value specific to the CodeSystem. It may not contain any term entered by the user. TODO Linda Bird Rob Hausam

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 identify a specific edition are listed here.


4.2.1.0.3 Display

TODO Advice on the following (requested from LP in comments):  What is the guidance when we need to refer to the language refset? what is the guidance when and if we want to define a display term for an expression? What if another term than the preferred term is selected for the display term?

Any number of terms in additional languages and dialects can be specified for a given code in the "Designation" field (eg Any number of terms in additional languages and dialects can be specified for a given code in the "Designation" field (eg ValueSet.compose.include.concept.designation ) where the particular language refset to be referred to can be mapped from the language code field  "Language"(eg ValueSet.compose.include.concept.designation.language)  where the particular language refset to be referred to can be mapped from the language code field  "Language"(eg and the type of the term (ie FSN, Synonym, Definition) is held in the "Use" field ValueSet.compose.include.concept.designation.language)  and the type of the term (ie FSN, Synonym, Definition) is held in the "Use" field ValueSet.compose.include.concept.designation.use.use.

The ExpansionProfile resource can be used to augment information supplied in ValueSet elements on request.   Michael Lawley Reuben Daniels - can you help out here?   Also suggestion that the ValueSet is not the correct place to making language reference set available.   Rather it should be augmented locally in the specific implementation.   Suggestion that the display element should specify the language code, but perhaps this is better done in an extension rather than forcing everyone to deal with it (ie core).   Also since ValueSets can be defined using filters (ie intesionally) that display terms would not be relevant in this case.

TODO: CodeSystem Supplement.  Peter Jordan?


4.2.1.0.4 SNOMED CT Expressions

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normalFormTersestringGenerated Normal form expression for the provided code or expression, conceptIds only

New Sections Added

4.2.1.0.3 Display