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In the ValueSet resource any number of terms ('designations ') in additional languages and dialects can be specified for a particular concept in a value set definition using the ValueSet.compose.include.concept.designation  element. The language is specified as a BCP-47  language code as required by the 'designation.language ' element, with the value taken from the 'languageCode' field of the RF2 Descriptions file ('languageCode' is ISO-639-1, a subset of BCP-47). The type  of the term (e.g., the SNOMED CT code for "Fully specified name", "Synonym" or "Definition") can be specified in 'designation.use '.

[Note that ValueSet.compose.include.concept is only used when the value set is defined extensionally (i.e. as an enumerated list of concepts). For intensionally-defined value sets (i.e. using one or more filters) additional terms could be added using CodeSystem.concept.designation, as noted below.]

The CodeSystem resource can also similarly be used to specify additional terms ('designations ') for a concept using the CodeSystem.concept.designation  element (the additional terms may be from a published national or other localized SNOMED CT edition or provided in a code system supplement ). If supported by the terminology server, the additional terms are available to be returned in a value set expansion  (controlled by the $expand  operation 'includeDesignations' input parameter).

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