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SNOMED CT Releases: Important Notices & Known Issues

SNOMED CT to ICD-10 and OPCS-4 Classification Maps for the 34.1.0 – 10 August 2022 content

There will be no updates to the ICD-10 or OPCS-4.9 classification maps in the 34.1.0 – 10 August 2022 release.

The August 2022 SNOMED CT content will be mapped and included in the 35.0.0 - 05 October 2022 SNOMED CT UK Clinical Edition, which will also include the UK maps for SNOMED International Edition February 2022 to July 2022 releases.

SNOMED CT to ICD-10 and OPCS-4 Classification Maps for the 33.1.0 - 15 June 2022 content

Updates to the SNOMED CT to ICD-10 and OPCS-4 maps are included in the 33.0.0 – 18 May 2022 release, but there will be no further updates to the maps for the 33.1.0 - 15 June 2022 release.

The June 2022 SNOMED CT content will be mapped and included in the 34.0.0 - 13 July 2022 SNOMED CT UK Clinical Edition, which will also incorporate the maps for the SNOMED International January 2022 content.

Release ID 33.0.0 - 16 May 2022

Errors have been reported in relation to Release ID 33.0.0

SNOMED CT Drug extension simple map

The simple map refset file in the SNOMED CT UK Drug Extension release contains members that refer to a refset ID that does not exist in the corresponding concept table.

ID

EffectiveTime

Active

ModuleID

RefsetID

ReferencedComponentID

MapTarget

0b830cac-00cd-484c-a25f-bcdaf36b9ebd

20220511

1

999000021000001108

13088201000001103

1144607003

SUPPORTING_DATA

1f54fc6b-0fc7-44f4-bcb4-93a5a205b4a0

20220511

1

999000021000001108

13088201000001103

1155971003

SUPPORTING_DATA

20580ee7-c57d-42f7-83bf-a3bbbcead17e

20220511

1

999000021000001108

13088201000001103

1137367000

SUPPORTING_DATA

30fc0cdd-e86e-4dfc-a838-069a24851b8b

20220511

1

999000021000001108

13088201000001103

1148537007

SUPPORTING_DATA

38be27ca-1ef7-4db2-b7d8-0efecd318707

20220511

1

999000021000001108

13088201000001103

1149496005

SUPPORTING_DATA

4599da49-e615-4b46-b308-37729c07c1c9

20220511

1

999000021000001108

13088201000001103

1162689008

SUPPORTING_DATA

497231a5-4adc-4e1e-9a01-c51e559fc24f

20220511

1

999000021000001108

13088201000001103

1157170002

SUPPORTING_DATA

49aacf72-f54a-477f-8161-b8040c1d6df9

20220511

1

999000021000001108

13088201000001103

1145127006

SUPPORTING_DATA

55314bf8-3194-4e51-a869-74b4b449b1f8

20220511

1

999000021000001108

13088201000001103

1144477009

SUPPORTING_DATA

a5037b79-fb44-4b02-aef0-e24c9ca50e2a

20220511

1

999000021000001108

13088201000001103

1145150000

SUPPORTING_DATA

d218ba0f-4e8a-46f3-bd10-e295a6832744

20220511

1

999000021000001108

13088201000001103

1156877005

SUPPORTING_DATA

e84c5218-66c8-4142-9153-5d01dd866437

20220511

1

999000021000001108

13088201000001103

1148549008

SUPPORTING_DATA

efdee66a-89a5-4a84-a8b1-6259f0f3c0b7

20220511

1

999000021000001108

13088201000001103

1137366009

SUPPORTING_DATA

fb85fbbf-ba50-4957-8ae7-cbf00e271a84

20220511

1

999000021000001108

13088201000001103

1144610005

SUPPORTING_DATA

fd8f50cd-354c-4328-b647-e84053e002e4

20220511

1

999000021000001108

13088201000001103

372691000221100

SUPPORTING_DATA

The above members have all been released in error and will be removed from all release types in the 33.1.0 release.

SNOMED CT Clinical extension RLR entries

The following four concepts all lack entries in the 999001261000000100 |National Health Service realm language reference set (clinical part)| (the RLR) that refer to Active descriptions. Currently their RLR entries refer to Inactive descriptions:

  • 440701000124107 |Inadequate vitamin B6 intake (finding)|
  • 440711000124105 |Inadequate vitamin B12 intake (finding)|
  • 440741000124109 |Excessive vitamin B6 intake (finding)|
  • 440751000124106 |Excessive vitamin B12 intake (finding)|

All four concepts are Inactive.

This error will be fixed in the 33.1.0 release.

Release ID 32.10.0 - 23 February 2022

An error has been reported in relation to Release ID 32.10.0

The following six concepts relating to the pathology module:

  • 50321000237103 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) RNA nucleic acid amplification qualitative result
  • 50581000237106 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) IgM antibody in serum qualitative result
  • 51631000237101 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) antigen in serum qualitative result
  • 62641000237109 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) IgA antibody in serum qualitative result
  • 63001000237108 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) IgG antibody in serum qualitative result
  • 66641000237105 - SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) antibody in serum qualitative result

Were erroneously included within the following two refsets in the clinical refsets module:

  • 1321181000000108 - COVID-19 record extraction simple reference set
  • 999004331000000102 - Summary Care Record inclusion simple reference set

These have been removed and the relevant packs re-issued on the same day as the original release (23rd Feb 2022).

This affects the following release packages on TRUD:

UK SNOMED CT Clinical Edition, RF2: Full, Snapshot & Delta

UK SNOMED CT Clinical Edition, RF2: Delta

SNOMED CT human-readable subset - UK Clinical Extension

If you have downloaded the above packs on 23rd Feb 2022, you are advised to download them again and re-apply them.  If you use only the delta, the replacement delta will need to be applied to the 32.7.0 release as before

SNOMED CT to ICD-10 and OPCS-4 Classification Maps

Updates to the SNOMED CT to ICD-10 and OPCS-4 maps have been included in the 32.10.0 - 23 February 2022 release, but there will be no further map updates for the 32.12.0 - 20 April 2022 release.

The April 2022 SNOMED CT content will be mapped and included in the 33.0.0 - 18 May 2022 SNOMED CT UK Clinical Edition, which will also incorporate the maps for the SNOMED International July 2021 content

Release ID 32.6.0 – 03 November 2021

International release

The SNOMED CT UK Clinical edition is based on the January 2021 SNOMED International release.

The SNOMED International release notes can be found online at: SNOMED CT January 2021 International Edition release notes

You can find upcoming changes to the SNOMED International Edition release using the SNOMED International daily build browser, however, please note that these changes should not be used in the UK until they are released as part of the SNOMED CT UK Edition: Daily Build SNOMED CT Browser

Please find early visibility of SNOMED International releases using the SNOMED International Release Management page, this incorporates early visibility for the upcoming release and also history of early visibility information.

SNOMED CT UK Pathology extension

No changes

SNOMED CT UK Drug extension

SNOMED CT UK Drug Extension data is published on a four-weekly cycle. The refsets and bonus files supplied as part of the SNOMED CT UK Drug Extension are also updated and released on a four-weekly basis.

The 32.5.0 release (with dm+d data from release NHSBSA_9.2.0_20210920000001) of the SNOMED CT UK Drug Extension, will be synchronous with the October 2021 SNOMED CT UK Clinical Extension and the January 2021 SNOMED International Edition.

Clinical Content Changes

The following new SNOMED concepts have been added:

1365751000000105

FSN Application for medical exemption from severe acute respiratory syndrome coronavirus 2 vaccination approved (finding)

PT Application for medical exemption from COVID-19 vaccination approved

1365761000000108

FSN Application for medical exemption from severe acute respiratory syndrome coronavirus 2 vaccination rejected (finding)

PT Application for medical exemption from COVID-19 vaccination rejected

1365731000000103

FSN Vaccine-induced prothrombotic immune thrombocytopenia (disorder)

PT VITT - vaccine-induced immune thrombotic thrombocytopenia

Please note: we will not be updating the NHS Digital SNOMED CT Browser with the 32.6.0 release. These changes will be apparent when we update to the 32.7.0 release in December.

SNOMED CT to ICD-10 and OPCS-4 Classification Maps 

The ICD-10 map for 1365731000000103 Vaccine-induced prothrombotic immune thrombocytopenia (disorder) will be included in 32.7.0 - 01 December 2021 release.

The concepts 1365751000000105 Application for medical exemption from severe acute respiratory syndrome coronavirus 2 vaccination approved (finding) and 1365761000000108 Application for medical exemption from severe acute respiratory syndrome coronavirus 2 vaccination rejected (finding) are out of scope of ICD-10.

Information for future releases 

Should there be a requirement for the World Health Organization (WHO) to issue further emergency instructions outside of a scheduled SNOMED CT release (as was the case for COVID-19), the end user will need to assign the emergency ICD-10 code(s) manually via the ICD-10 Codes and Titles Metadata files (see the ‘SNOMED CT to ICD-10 and OPCS-4 Map Table Technical Specification and Implementation Guidance (UK Edition)’ release document for additional information).

Reference sets 

There are no new Reference sets in this release:

Technical notes 

There are currently no planned UK changes. Proposed SNOMED International changes can be found in the relevant release folder at: https://confluence.ihtsdotools.org/display/RMT/SNOMED+International+Release+Management+Home.

Known issues 

There are no known issues for this release.

Notification of SNOMED CT UK Clinical Edition MICRO release 03 November 2021

NHS Digital intend to release an unscheduled SNOMED CT UK Clinical Edition MICRO release on 03-Nov-2021.

This release is to support urgent COVID-19 pandemic requirements. The release contains 3 additional concepts.

  • Application for medical exemption from COVID-19 vaccination approved
  • Application for medical exemption from COVID-19 vaccination rejected
  • VITT - vaccine-induced immune thrombotic thrombocytopenia

The release will be available on TRUD as normal and will have a Release ID of 32.6.0 with an Effective Time of 27-Oct-2021.

Further information on the content of this release will be made available at the point of release.

SNOMED CT UK Clinical Edition 32.4.0 Micro – 08 September 2021

This release of the SNOMED CT UK Clinical Edition is a ‘Micro’ release containing only minimal changes to support the COVID-19 pandemic response.  

The following concepts are new for this release: 

  • 1363831000000108 Administration of fifth dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure) 
  • 1363791000000101 Administration of fourth dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure) 
  • 1363861000000103 Administration of third dose of severe acute respiratory syndrome coronavirus 2 vaccine (procedure) 
  • 1363851000000101 Severe acute respiratory syndrome coronavirus 2 vaccination fifth dose declined (situation) 
  • 1363841000000104 Severe acute respiratory syndrome coronavirus 2 vaccination fifth dose not given (situation) 
  • 1363811000000100 Severe acute respiratory syndrome coronavirus 2 vaccination fourth dose declined (situation) 
  • 1363821000000106 Severe acute respiratory syndrome coronavirus 2 vaccination fourth dose not given (situation) 
  • 1363781000000103 Severe acute respiratory syndrome coronavirus 2 vaccination third dose declined (situation) 
  • 1363771000000100 Severe acute respiratory syndrome coronavirus 2 vaccination third dose not given (situation) 

Support on the usage of these concepts will be published in the COVID-19 Vaccination codes document on the COVID-19 Information Standards page.  

Please note: There are no updates to the ICD-10 or OPCS-4.9 classification maps for this Micro release. These will be included in the next scheduled Clinical release.  

SNOMED CT Browser not displaying the current release data

Sometimes following an update the most recent SNOMED CT UK edition content might not display correctly within the SNOMED CT Browser. This can be as a result of your browser (such as Chrome, Edge or Firefox) using its own stored data to automatically default to the last published release.

There are two workarounds for this:

  1. Open the browser using a privacy mode such as incongnito mode in Chrome, InPrivate view in Edge or Private Window in Edge.
  2. Clear your browsing data within your browser
    1. Chrome: Menu: Settings: Privacy and Security: Clear Browsing Data
    2. Edge: Menu: Settings: Privacy and Security: Clear Browsing Data
    3. Firefox: Menu: Option Preferences: Privacy and Security: Cookies and Site Data: Clear Data

If you continue to experience any further problems following then please contact  information.standards@nhs.net

Known Error - Duplicate Cross Maps within SNOMED CT RF2

There is a known issue of duplicate rows within the cross-map files. This has been present for a number of releases and we are currently investigating the issue

Changes to 2021/22 SNOMED CT and NICIP releases

After a very active and dynamic period responding to COVID-19 priorities we have taken stock of our Terminology Service and introduced changes to the 2021/22 release schedule whilst we build greater resilience, stabilise our release processes after significant process changes during the pandemic, enhance and grow our team. 

The following approach will be effective immediately:

These changes will continue until we are in a better position to resume full-service levels.

Updates and releases of the National Interim Clinical Imaging Procedure (NICIP) code set have been placed on hold with immediate effect to allow the outcome of the following:

  • a formal position is being sought from NHSX on the strategic direction of NICIP and the long-term intention to move to the use of a single terminology of SNOMED CT
  • NHS England and Improvement are looking to commission a piece of discovery work that aims to identify how to improve the collection, utility, and dissemination of the Diagnostic Imaging Dataset: this could include reviewing opportunities and impacts of updating NICIP and/or transition to SNOMED CT

In the meantime NICIP code requests can continue to be submitted to the Request Submission Portal where these will be logged until we are in a position to process them.

Any queries should be submitted to our helpdesk: information.standards@nhs.net.

SNOMED CT UK Clinical Edition 32.0.0 - 19 May 2021

Important changes and information regarding this release

This release of the SNOMED CT UK Clinical Edition is based upon the January 2021 International Edition. Changes have been made to the SNOMED CT UK Clinical Edition and includes new COVID-19 content.

"On examination" and "Complaining of" concepts

In the January 2021 International release content relating to ‘On examination’ and ‘Complaining of’ concepts have been inactivated. A decision was made by the UK Edition Committee that this content needed to be made active in the UK Clinical extension due to the usage of these concepts in primary care.  This content has been reactivated for the 32.0.0 release of the SNOMED CT UK Clinical Edition.

Please note we are aware of an issue with the NHS Digital SNOMED CT browser (Termbrowser) which means the reactivated ‘On examination’ and ‘Complaining of’ concepts are not displayed correctly. We are working to fix the issue. Please read the SNOMED CT UK Clinical Extension Release Documentation for more information.

Advice on competing International and UK SNOMED CT codes

NHS Digital are aware of several new codes in the January 2021 International data (and thus in the May 2021 UK Edition) of SNOMED CT. These new codes may interfere with established UK recording of certain COVID-19 and SARS-CoV-2 data items. For example:

  • diagnostic codes for the long-term effects of COVID-19
  • SARS-CoV-2 vaccinations and adverse reactions
  • SARS-CoV-2 antibody test results.

A document COVID-19 and SARS-CoV-2 in SNOMED CT: Advice on competing International and UK codes has been produced to highlight the issues and provide advice on the steps which can be taken to minimise the impact on data quality.

SNOMED CT UK Clinical Edition 31.5.0 - 24 March 2021

Important changes and information regarding this release

This release of the SNOMED CT UK Clinical Edition® update is based on the July 2020 International Edition. Changes have been made to the SNOMED CT UK Clinical Edition and includes new COVID-19 content.

IMPORTANT CODE ADDITIONS OF NOTE WITHIN 31.5.0 UK CLINICAL EXTENSION

1325901000000103| QCovid risk calculator (assessment scale)

1325891000000104| Assessment using QCovid risk calculator (procedure)

1325921000000107| QCovid risk calculator COVID associated death relative risk score (observable entity)

1325911000000101| QCovid risk calculator COVID associated death absolute risk score (observable entity)

1325931000000109| QCovid risk calculator COVID associated hospital admission relative risk score (observable entity)

1325941000000100| QCovid risk calculator COVID associated hospital admission absolute risk score (observable entity)

1325961000000104| NHS Digital COVID-19 Clinical Risk Assessment Tool (assessment scale)

1325951000000102| Assessment using NHS Digital COVID-19 Clinical Risk Assessment Tool (procedure)

1325981000000108| NHS Digital COVID-19 Clinical Risk Assessment Tool combined risk of catching and dying from COVID-19 relative risk score (observable entity)

1325991000000105| NHS Digital COVID-19 Clinical Risk Assessment Tool combined risk of catching and hospitalisation from COVID-19 relative risk score (observable entity)

1325971000000106| NHS Digital COVID-19 Clinical Risk Assessment Tool combined risk of catching and dying from COVID-19 absolute risk score (observable entity)

1326001000000109| NHS Digital COVID-19 Clinical Risk Assessment Tool combined risk of catching and hospitalisation from COVID-19 absolute risk score (observable entity)

Future release schedule

The Next Scheduled Release is

19 May 2021 TRUD Version 32.0.0 effectiveTime 20210512 Base content: January 2021 SNOMED CT International Edition New content: Any urgent COVID-19 content (as per a microrelease) ICD10 and OPCS map updates covering above new content Technical update of refsets to align with new content

Please note: the opportunity and need for a further emergency unscheduled microrelease of COVID-19 specific content in addition to the above is not excluded by the above schedule: a further release on 16 June 2021 could therefore still occur, to coincide with the already scheduled 4-weekly release of the SNOMED CT UK Drug Extension.

A timetable for seven scheduled releases annually through 2021 and beyond is now posted here on DELEN

Reference sets (Refsets)

This SNOMED CT UK Edition Release is based on the July 2020 International Edition.

We have no refsets due for retirement.

Cross Mapping

The 31.5.0 mapping files includes only a small number of new UK concepts. The majority of changes made are to existing content. For further information, please see the ‘SNOMED CT to ICD-10 and OPCS-4 Classification maps - Change Report’.

SNOMED CT International Edition

No changes have been made to the SNOMED CT International Edition for this release. We will next update the SNOMED CT UK Edition with new International Content scheduled for release on 19 May 2021. Anyone wanting early sight of the expected changes can follow the links below:

The Daily Build Report within the SNOMED International Browser SNOMED International: January 2021 Release Notes

Please note: Any content (including COVID-19 content) from the International Release should only be used once incorporated into the UK Edition and in relation to COVID-19 content only if approved. Please see our guidance information on Delen for further details.

Planned Changes to the SNOMED CT UK Edition Release Subfolder Structure from 19 May 2021

Planned changes to the SNOMED CT UK Edition release subfolder structure

Subscribers were previously advised that all future PRODUCTION releases of the Drug and Clinical extension content would transition from April 2020 to the BETA release bundling previously provided as technology previews.

For a more detailed explanation of the motivations for the BETA bundling, see the webinar recording. Detailed information is also provided in the UK Clinical Edition SNOMED CT Technical overview document, section 2.4.1 and 2.4.2.

To reduce burden during the pandemic, this transition was deferred. Suppliers remain recommended to transition to consuming the BETA rather than PRODUCTION bundlings, in accordance with the following revised schedule:

Throughout the remainder of 2020, PRODUCTION releases will remain as before but with the same content always co-published on TRUD in BETA format, as Test Releases.

From the first scheduled release in 2021 (expected 19 May), all PRODUCTION releases of UK Clinical and Drug will adopt the BETA encoding. All releases will then continue to be available in parallel in the older LEGACY encoding until the end of July 2021, after which the LEGACY encoding variant will be permanently withdrawn.

SNOMED CT UK Clinical Edition 31.3.0 - 27 January 2021

Important changes and information regarding this release:

This is the first minor of the SNOMED CT UK Clinical Edition® update based on the July 2020 International Edition. Changes have been made to the SNOMED CT UK Clinical Edition and includes new COVID-19 and non-COVID-19 content. 

IMPORTANT CODE ADDITIONS OF NOTE WITHIN 31.3.0 UK CLINICAL EXTENSION 

12 New SNOMED codes have been created for COVID Oximetry @home providers to use 

1325251000000106 Referral to telehealth pulse oximetry monitoring service (procedure) 

1325261000000109 Referral by telehealth pulse oximetry monitoring service (procedure) 

1325271000000102 Discharge from telehealth pulse oximetry monitoring service (procedure) 

1325201000000105 Telehealth pulse oximetry monitoring ended (situation) 

1325191000000108 Telehealth pulse oximetry monitoring started (situation) 

1325211000000107 Provision of pulse oximeter (procedure) 

1325221000000101 Telehealth pulse oximetry monitoring not appropriate (finding) 

1325241000000108 Telehealth pulse oximetry monitoring declined (situation) 

1325281000000100 Discussion about telehealth pulse oximetry monitoring (procedure) 

1325681000000102 Has access to pulse oximeter (finding) 

1325701000000100 Oxygen saturation at periphery equivocal (finding) 

1325691000000100 Oxygen saturation at periphery unknown (finding) 

Future release schedule

The Next Scheduled Release is 

24 March 2021 

TRUD Version   31.5.0 
effectiveTime    20210317 

Base content:    July 2020 SNOMED CT International Edition 

New content:       Any urgent COVID-19 content (as per a microrelease) 
                        ICD10 and OPCS map updates covering above new content 
                        Full update of refsets to align with new content 

Please note: the opportunity and need for a further emergency unscheduled microrelease of COVID-19 specific content in addition to the above is not excluded by the above schedule: a further release on 24 February 2021 could therefore still occur, to coincide with the already scheduled 4-weekly release of the SNOMED CT UK Drug Extension. 

A timetable for seven scheduled releases annually through 2021 and beyond is now posted here on DELEN 

Reference sets (Refsets)

This is the second minor SNOMED CT update based on the July 2020 International Edition. Although most refsets have received a minimum uplift there could be some refsets which have received more substantial uplifts.  

We have no refsets due for retirement.  

Cross Mapping

The 31.3.0 mapping files include a small number of new priority UK concepts, in addition to changes to some existing concepts.  For further information, please see the SNOMED CT to ICD-10 and OPCS-4 Classification Maps Change Report. 

SNOMED CT International Edition

No changes have been made to the SNOMED CT International Edition for this release. We will next update the SNOMED CT UK Edition with new International Content scheduled for release on 19 May 2021. Anyone wanting early sight of the expected changes can follow the links below   

The Daily Build Report within the SNOMED International Browser 

SNOMED International: January 2021 Release Notes 

Please note: COVID-19 related content from the International Release should only be used in the UK if approved. Please see our guidance information on Delen for further details.  

Subscriptions and licensing

Please note: If your details have changed, please can you update your information on the TRUD registration page, https://isd.hscic.gov.uk/trud3 . This is particularly important if you plan to deploy SNOMED CT enabled applications outside SNOMED CT International Member territories as there are additional licensing considerations. 

The above releases can also be downloaded via our FTP servers if you have previously been assigned an FTP access right. Details of the new API service is available on TRUD.  

Regards  
The TRUD support team  
NHS Digital 

Telephone number:  0300 30 34 777 

e-mail to information.standards@nhs.net