© 2024 International Health Terminology Standards Development Organisation. All rights reserved. SNOMED CT® was originally created by the College of American Pathologists.
This document forms part of the SNOMED CT® New Zealand Extension release distributed by International Health Terminology Standards Development Organisation, trading as SNOMED International, and is subject to the SNOMED CT® Affiliate License, details of which may be found at https://www.snomed.org/snomed-ct/get-snomed
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Page At A Glance
Introduction
Te Whatu Ora - Health New Zealand works with health agencies and their industry partners to develop SNOMED CT® reference sets, maps, language reference sets and other content for digital health solutions in Aotearoa New Zealand.
The SNOMED CT New Zealand Extension packages these components for release every April and October, to be used with the latest designated SNOMED CT International Edition release.
The content can be downloaded from our member licensing and distribution service, viewed online using the SNOMED CT browser or accessed via FHIR® API using the NZ Health Terminology Service.
We welcome your feedback and participation. For more information about SNOMED CT implementation in New Zealand, see our website or join our standards channel at ehealthforum.nz.
Background
This document provides a summarized description of the content changes included in the October 2023 production release of the SNOMED NZ Extension package.
It also includes technical notes detailing any known issues.
This SNOMED NZ Extension package is dependent upon and should therefore be consumed in conjunction with the SNOMED CT International Edition July 2023 release.
Content development activity
Summary
Content from the SNOMED CT International Edition July 2023 release has been incremented, using additional components for use in New Zealand.
The October 2023 release includes updates to the previously released content in the SNOMED NZ Extension and introduces some new content.
This release includes new content in the following areas.
Health consumer information
The New Zealand health consumer information reference set consists of common terms used on websites and in patient information leaflets to describe diseases, tests and treatments (other than medicines) in a form consumers and whānau can understand. This content has been developed in partnership with Health Navigator.
Family planning
The New Zealand Family Planning reference set identifies common symptoms, diagnoses and procedures that are referred to when seeing patients for their sexual and reproductive health. This content has been developed in partnership with New Zealand Family Planning.
Minor procedures
A collection of five reference sets has standard codes for recording minor procedures performed in outpatient clinics. Reporting the procedure performed for the five purchase units listed below will reduce the number of new purchase units required for specific procedures and will allow more accurate counting of some procedures – for example, when NNPAC data is linked to hospital costing data.
The five reference sets are:
- New Zealand purchase unit code S00008 minor operation reference set
- New Zealand purchase unit code S25006 ear, nose and throat minor operation reference set
- New Zealand purchase unit code S30008 gynaecology minor procedure reference set
- New Zealand purchase unit code S40008 eye procedure reference set
- New Zealand purchase unit code S60007 plastic surgery minor procedure reference set
CanShare
Te Aho o Te Kahu (Cancer Control Agency) has produced a collection of 72 reference sets for recording, sharing and querying cancer data on the CanShare platform. The collection includes Anti-Cancer Therapy - Nationally Organised Workstreams (ACT-NOW) reference sets, histology reference sets for haematolymphoid tumours (based on the WHO Classification of Tumours, 5th edition), TNM cancer staging reference sets for breast and haematologic malignancies (based on the AJCC cancer staging manual, 8th edition) and general reference sets used across a range of cancer data.
New and updated content
Concept statistics
The SNOMED NZ National Release Centre promoted 12 new concepts to the SNOMED CT International Edition January 2023 release.
Table 1. New concepts in the SNOMED International January 2023 release by hierarchy
| Total number of concepts | 12 |
|---|---|
| Clinical finding (finding) | 4 |
| Procedure (procedure) | 4 |
| Qualifier value (qualifier value) | 4 |
There are 362 new concepts in our October 2023 release.
Table 2. New concepts in the SNOMED NZ Extension October 2023 release by hierarchy
Total number of concepts | 362 |
|---|---|
Body structure (body structure) | 68 |
Clinical finding (finding) | 28 |
Observable entity (observable entity) | 1 |
Procedure (procedure) | 129 |
Qualifier value (qualifier value) | 9 |
Record artifact (record artifact) | 3 |
SNOMED CT Model Component (metadata) | 86 |
Situation with explicit context (situation) | 21 |
Staging and scales (staging scale) | 17 |
Description statistics
The SNOMED NZ NRC promoted 4 new descriptions to the SNOMED International Edition January 2023 release.
There are 1253 new descriptions in our October 2023 release.
For a statistical breakdown of the content of the SNOMED NZ Extension and the October 2023 release please visit release statistics site.
Reference sets
There are 138 reference sets in the October 2023 release including 79 new reference sets. The new reference sets cover family planning, health consumer information and CanShare reference sets.
For more information about New Zealand reference sets, please visit our website.
The New Zealand reference set list is available in Appendix 1, table 1.1.
Language reference sets
Language reference sets are created to define preferred terms and synonyms associated with each concept. There are three language reference sets in the October 2023 release.
Language Reference Set Name | SNOMED CT Concept ID (SCTID) | Members |
|---|---|---|
Maori [International Organization for Standardization 639-1 code mi] language reference set (foundation metadata concept) | 291000210106 | 157 |
New Zealand English language reference set (foundation metadata concept) | 271000210107 | 1266965 |
New Zealand English patient friendly terms language reference set (foundation metadata concept) | 281000210109 | 162 |
New Zealand CanShare language reference set (foundation metadata concept) | 231621000210105 | 1662 |
Maps
Five maps between SNOMED CT and other code systems are contained in the October 2023 release.
Map Name | SNOMED CT Concept ID (SCTID) | Members |
|---|---|---|
ACC translation table map (foundation metadata concept) | 401000210101 | 12794 |
MSD translation table map (foundation metadata concept) | 411000210104 | 58133 |
NZMT medicinal product to SNOMED CT map (foundation metadata concept) | 311000210107 | 2125 |
READ v2 to SNOMED CT map (foundation metadata concept) | 31000210106 | 88273 |
SNOMED CT to READ v2 map (foundation metadata concept) | 41000210103 | 66966 |
Technical notes
Known issues
Known issues are content or technical issues where the root cause is understood and the resolution has been discussed and agreed but has yet to be implemented. This can be due to a number of reasons, from lack of capacity within the current editing cycle, to the risk of impact to the stability of SNOMED CT if the fix were to be deployed at that stage in the product lifecycle.
The following known issues were identified, and agreed to be resolved in the next editing cycle:
Notice of changes to the International Edition release schedule
The SNOMED CT International Edition has moved to a monthly release cycle. These more frequent releases of SNOMED CT will realize several benefits, including:
- The potential to be able to get content changes into the terminology in a shorter time frame.
- The fostering of better interoperability, as a result of entities being able to consume release content that is more aligned with other organizations.
- The prevention of circular dependencies that occur in longer projects, due to the move towards smaller, more manageable authoring projects.
- More automated validation services, as a result of the inherent removal of the Alpha/Beta stages in the Release cycle.
Whilst most users will continue unaffected (as they can simply continue to download the releases every 6 months as always), this transition will necessarily involve a few changes to process/packages:
- Delta files have been removed from releases of the SNOMED CT International Edition and SNOMED NZ Extension. A Delta Generation service will be provided for those who need it. The Delta Generation Tool allows users to create their own Delta between two fixed release dates - you can find it here:
- The ICD-O/ICD-10 Maps will continue to be published in each Monthly International Edition release package (in line with that month's content) for the foreseeable future, unless we experience issues with the new process in Production, and they need to be removed at a later date.
The first monthly Release of the SNOMED CT International Edition was published on the 28th February 2022 with the Delta files having been removed, and therefore they will be removed from the New Zealand Extension from the April 2022 Release onwards.
Please note - While the SNOMED CT International Edition is moving to monthly releases, the New Zealand Extension of SNOMED CT will remain on the current bi-annual release schedule of April and October for 2023.
Appendix 1
Table 1.1 Reference sets in the SNOMED NZ Extension October 2023 release
SNOMED CT Concept ID (SCTID) | SNOMED CT Preferred Term | Members |
|---|---|---|
351000210106 | New Zealand adverse reaction manifestation reference set | 1887 |
253671000210109 | New Zealand AJCC cancer staging manual edition reference set | 2 |
253701000210108 | New Zealand AJCC carcinoma of breast clinical M category reference set | 3 |
253531000210106 | New Zealand AJCC carcinoma of breast clinical N category reference set | 11 |
253741000210106 | New Zealand AJCC carcinoma of breast clinical stage group reference set | 9 |
253491000210106 | New Zealand AJCC carcinoma of breast clinical T category reference set | 16 |
253721000210100 | New Zealand AJCC carcinoma of breast pathological M category reference set | 1 |
253551000210100 | New Zealand AJCC carcinoma of breast pathological N category reference set | 16 |
253751000210109 | New Zealand AJCC carcinoma of breast pathological stage group reference set | 9 |
253511000210104 | New Zealand AJCC carcinoma of breast pathological T category reference set | 16 |
253651000210101 | New Zealand AJCC clinical M category reference set | 15 |
253471000210107 | New Zealand AJCC clinical N category reference set | 19 |
253681000210106 | New Zealand AJCC clinical stage group reference set | 140 |
253451000210104 | New Zealand AJCC clinical T category reference set | 39 |
253251000210103 | New Zealand AJCC grade reference set | 9 |
253711000210105 | New Zealand AJCC haematologic malignancy clinical M category reference set | 2 |
253541000210103 | New Zealand AJCC haematologic malignancy clinical N category reference set | 9 |
253501000210101 | New Zealand AJCC haematologic malignancy clinical T category reference set | 11 |
253731000210103 | New Zealand AJCC haematologic malignancy pathological M category reference set | 1 |
253561000210102 | New Zealand AJCC haematologic malignancy pathological N category reference set | 9 |
253521000210109 | New Zealand AJCC haematologic malignancy pathological T category reference set | 11 |
253771000210101 | New Zealand AJCC haematology chronic lymphocytic leukemia or small lymphocytic lymphoma stage group reference set | 5 |
253761000210107 | New Zealand AJCC haematology Hodgkin or non-Hodgkin lymphoma stage group reference set | 7 |
253821000210106 | New Zealand AJCC haematology mycosis fungoides or sezary syndrome clinical M category reference set | 2 |
253611000210100 | New Zealand AJCC haematology mycosis fungoides or sezary syndrome clinical N category reference set | 9 |
253571000210108 | New Zealand AJCC haematology mycosis fungoides or sezary syndrome clinical T category reference set | 8 |
253841000210100 | New Zealand AJCC haematology mycosis fungoides or sezary syndrome pathological M category reference set | 1 |
253631000210107 | New Zealand AJCC haematology mycosis fungoides or sezary syndrome pathological N category reference set | 9 |
253591000210107 | New Zealand AJCC haematology mycosis fungoides or sezary syndrome pathological T category reference set | 8 |
253801000210103 | New Zealand AJCC haematology mycosis fungoides or sezary syndrome stage group reference set | 10 |
253781000210104 | New Zealand AJCC haematology paediatric Hodgkin lymphoma stage group reference set | 7 |
253791000210102 | New Zealand AJCC haematology paediatric non-Hodgkin lymphoma stage group reference set | 4 |
253811000210101 | New Zealand AJCC haematology plasma cell myeloma stage group reference set | 3 |
253831000210108 | New Zealand AJCC haematology primary cutaneous B cell or T cell (non-MF/SS) lymphoma clinical M category reference set | 2 |
253851000210102 | New Zealand AJCC haematology primary cutaneous B cell or T cell (non-MF/SS) lymphoma pathological M category reference set | 1 |
253581000210105 | New Zealand AJCC haematology primary cutaneous B-cell or T-cell (non-MF/SS) lymphoma clinical T category reference set | 10 |
253601000210102 | New Zealand AJCC haematology primary cutaneous B-cell or T-cell (non-MF/SS) lymphoma pathological T category reference set | 10 |
253641000210104 | New Zealand AJCC haematology primary cutaneous haematology B cell or T cell (non-MF/SS) lymphoma pathological N category reference set | 5 |
263581000210104 | New Zealand AJCC haematology stage group reference set | 17 |
253661000210103 | New Zealand AJCC pathological M category reference set | 13 |
253481000210109 | New Zealand AJCC pathological N category reference set | 20 |
253691000210108 | New Zealand AJCC pathological stage group reference set | 139 |
253461000210101 | New Zealand AJCC pathological T category reference set | 38 |
253621000210105 | New Zealand AJCC primary haematology cutaneous B cell or T cell (non-MF/SS) lymphoma clinical N category reference set | 5 |
72671000210109 | New Zealand alcohol consumption reference set | 3 |
421000210109 | New Zealand ambulance clincial impression refset | 176 |
61241000210100 | New Zealand biological substance common allergen reference set | 207 |
253111000210109 | New Zealand cancer data absent reason reference set | 5 |
253301000210109 | New Zealand cancer ECOG status reference set | 6 |
253331000210104 | New Zealand cancer ER expression reference set | 2 |
253281000210108 | New Zealand cancer grading system reference set | 1 |
253871000210105 | New Zealand cancer haematology treatment intent reference set | 5 |
253351000210105 | New Zealand cancer HER2 expression reference set | 2 |
253241000210101 | New Zealand cancer laterality reference set | 5 |
253341000210107 | New Zealand cancer PR expression reference set | 2 |
253321000210101 | New Zealand cancer prognostic scoring system reference set | 17 |
253291000210105 | New Zealand cancer recurrence type reference set | 5 |
253861000210104 | New Zealand cancer solid tumour treatment intent reference set | 6 |
253311000210106 | New Zealand cancer staging system reference set | 11 |
253361000210108 | New Zealand cancer treatment intent reference set | 8 |
91000210107 | New Zealand cardiology reference set | 63 |
61251000210102 | New Zealand chemical substance common allergen reference set | 619 |
191000210102 | New Zealand child developmental services reference set | 137 |
241000210102 | New Zealand child health assessment reference set | 186 |
471000210108 | New Zealand clinical specialty reference set | 157 |
61271000210105 | New Zealand common pharmaceutical dose form reference set | 12 |
61281000210107 | New Zealand common pharmaceutical dose frequency reference set | 12 |
61291000210109 | New Zealand common pharmaceutical dose unit reference set | 11 |
61231000210108 | New Zealand COVID-19 adverse event from immunisation reference set | 60 |
261000210101 | New Zealand disability reference set | 96 |
61261000210104 | New Zealand edible substance common allergen reference set | 419 |
61000210102 | New Zealand emergency care diagnosis reference set | 1466 |
71000210108 | New Zealand emergency care presenting complaint reference set | 158 |
321000210102 | New Zealand emergency care procedure reference set | 74 |
141000210106 | New Zealand endocrinology reference set | 263 |
263311000210103 | New Zealand family planning reference set | 250 |
181000210104 | New Zealand general paediatric reference set | 441 |
131000210103 | New Zealand general surgery reference set | 97 |
101000210108 | New Zealand gynaecology reference set | 147 |
263301000210100 | New Zealand health consumer information reference set | 84 |
451000210100 | New Zealand health occupation reference set | 87 |
461000210102 | New Zealand health service type reference set | 228 |
501000210102 | New Zealand laboratory order reference set | 956 |
72621000210105 | New Zealand maternity Apgar score reference set | 33 |
72631000210107 | New Zealand maternity complementary therapies reference set | 21 |
72601000210102 | New Zealand maternity complications reference set | 34 |
72611000210100 | New Zealand maternity disorders reference set | 49 |
72661000210103 | New Zealand maternity family history reference set | 12 |
72591000210107 | New Zealand maternity findings reference set | 159 |
72581000210105 | New Zealand maternity mode of delivery reference set | 6 |
72571000210108 | New Zealand maternity outcomes reference set | 8 |
72541000210103 | New Zealand maternity previous complications reference set | 47 |
72551000210100 | New Zealand maternity previous disorders reference set | 59 |
72531000210106 | New Zealand maternity previous findings reference set | 50 |
72521000210109 | New Zealand maternity previous mode of delivery reference set | 10 |
72511000210104 | New Zealand maternity previous outcomes reference set | 9 |
72501000210101 | New Zealand maternity previous procedures reference set | 23 |
72561000210102 | New Zealand maternity procedures reference set | 57 |
72641000210104 | New Zealand maternity screening and tests reference set | 31 |
72651000210101 | New Zealand maternity substances reference set | 13 |
391000210104 | New Zealand microorganism reference set | 18571 |
50931000210104 | New Zealand nephrology reference set (foundation metadata) | 99 |
72691000210108 | New Zealand non-medicinal drug reference set | 16 |
72681000210106 | New Zealand non-medicinal drug use reference set | 6 |
251000210104 | New Zealand notifiable disease reference set | 97 |
50941000210107 | New Zealand ophthalmology reference set | 64 |
192081000210101 | New Zealand priority score reference set (foundation metadata concept) | 7 |
251621000210109 | New Zealand purchase unit code S00008 minor operation reference set | 71 |
251631000210106 | New Zealand purchase unit code S25006 ear, nose and throat minor operation reference set | 62 |
251641000210103 | New Zealand purchase unit code S30008 gynecology minor procedure reference set | 34 |
251651000210100 | New Zealand purchase unit code S40008 eye procedure reference set | 47 |
251661000210102 | New Zealand purchase unit code S60007 plastic surgery minor procedure reference set | 18 |
121531000210107 | New Zealand radiology procedures reference set | 914 |
192071000210103 | New Zealand referral status reference set | 7 |
121000210100 | New Zealand rheumatology reference set | 126 |
253131000210102 | New Zealand SACT basis of diagnosis reference set | 2 |
253401000210100 | New Zealand SACT disease response reference set | 4 |
253411000210103 | New Zealand SACT dose adjustment reason reference set | 18 |
263511000210105 | New Zealand SACT dose form reference set | 3 |
253421000210108 | New Zealand SACT dose unit reference set | 22 |
253121000210104 | New Zealand SACT observation code reference set | 21 |
253371000210102 | New Zealand SACT overall discontinue reason reference set | 11 |
253381000210100 | New Zealand SACT patient factor discontinue reason reference set | 9 |
253441000210102 | New Zealand SACT route of administration reference set | 24 |
253391000210103 | New Zealand SACT toxicity discontinue reason reference set | 15 |
121521000210105 | New Zealand severe acute respiratory syndrome coronavirus 2 symptoms reference set | 19 |
481000210105 | New Zealand site of care reference set | 9 |
72731000210103 | New Zealand smoking intervention reference set | 5 |
72741000210106 | New Zealand smoking status reference set | 4 |
441000210103 | New Zealand surgical complication reference set | 147 |
192091000210104 | New Zealand suspicion of cancer reference set (foundation metadata concept | 4 |
72721000210100 | New Zealand vaping status reference set | 7 |
263341000210102 | New Zealand WHO classification of tumours haematolymphoid B cell lymphoid proliferation or lymphoma histology reference set | 89 |
263331000210105 | New Zealand WHO classification of tumours haematolymphoid histiocytic dendritic cell neoplasm histology reference set | 12 |
263321000210108 | New Zealand WHO classification of tumours haematolymphoid myeloid proliferation or neoplasm histology reference set | 76 |
263361000210101 | New Zealand WHO classification of tumours haematolymphoid stroma derived neoplasm of lymphoid tissue histology reference set | 6 |
263351000210104 | New Zealand WHO classification of tumours haematolymphoid T cell and NK cell lymphoid proliferation or lymphoma histology reference set | 42 |
253231000210109 | New Zealand WHO classification of tumours haematolymphoid tumour histology reference set | 224 |
Draft Amendment History
Version | Date | Editor | Comments |
|---|---|---|---|
0.1 |
| Andrew Atkinson | Initial draft created |
| 0.2 | Lea Miharsa | First draft | |
| 1.0 | Alastair Kenworthy | Final draft |
Approvals
Final Version | Date | Approver | Comments |
|---|---|---|---|
| 0.2 | Lea Miharsa | Reviewed | |
| 1.0 | Alastair Kenworthy | Approved |