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Date

20250515

Document Version

1.0

Release Status

PRODUCTION

  © 2026 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® Belgium 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/get-snomed

No part of this document may be reproduced or transmitted in any form or by any means, or stored in any kind of retrieval system, except by an Affiliate of SNOMED International in accordance with the SNOMED CT® Affiliate License. Any modification of this document (including without limitation the removal or modification of this notice) is prohibited without the express written permission of SNOMED International.

Any copy of this document that is not obtained directly from SNOMED International [or a Member of SNOMED International] is not controlled by SNOMED International, and may have been modified and may be out of date. Any recipient of this document who has received it by other means is encouraged to obtain a copy directly from SNOMED International [or a Member of SNOMED International. Details of the Members of SNOMED International may be found at http://www.snomed.org/members/].

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Introduction

SNOMED CT terminology provides a common language that enables a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.

The International Health Terminology Standards Development organization (IHTSDO®), trading as SNOMED International, maintains the SNOMED CT technical design, the content architecture, the SNOMED CT content (includes the concepts table, the descriptions table, the relationships table, a history table, and ICD mappings), and related technical documentation.


Background

This document provides a summarized description of the content changes included in the May 2025 Production release of the SNOMED Clinical Terms® Managed Service Belgium Edition package.

It also includes technical notes detailing the known issues which have been identified (should any of these exist). These are content or technical issues where the root cause is understood, and the fix has been discussed and agreed, but has yet to be implemented.


2.1 Scope

This document is written for the purpose described above and is not intended to provide details of the technical specifications for SNOMED CT or encompass every change made during the release.


 Content Development Activity

Summary

This extension contains concepts, relationships and reference sets with their Dutch, French and German translations for healthcare professionals/for use in healthcare profession.

Warning about an unplanned change in the release schedule of the SNOMED CT Belgium Edition

Due to unforeseeable circumstances, the April 2025 release of the SNOMED CT Belgium Edition, which was due for publication on 15 April 2025, could not be published. The present May 2025 is the release that immediately follows the March 2025 release. The present release includes international content updates up to and including the May 2025 SNOMED CT International Edition.

 New and Updated Content

New Belgian content in this release

Inactivated concepts

1 Belgian concept has been inactivated: 1021000172105 |Tendinitis of elbow (disorder)| has been replaced by newly-created international concept 1363606006 |Tendinitis of elbow (disorder)|. The Dutch and French descriptions of the inactivated concept will be transferred to the new concept in the next Belgian release.

New concepts

No new Belgian concepts have been created in this release.

New translated content

  • GP language reference sets: the following table contains the total number of translations included in the GP language reference set:



Preferred

Acceptable

Total

DUTCH

11685

6173

17858

FRENCH

10943

5199

16142

TOTAL

226281137234000
  • New translations have been introduced to our national language reference sets, both for concepts that had not been yet translated and for concepts that already contained translations. Some existing translations were inactivated or updated.
  • The following table contains the total number of currently active translations available in the present version of the Belgian language reference sets:



Preferred

Acceptable

Total

DUTCH

308105

356569

664674

FRENCH

214121

130388

344509

GERMAN

41795

13459

55254

TOTAL

5640215004161064437


Summary of other changes

Differences found in package Comparison

No RF2 records impacted

Rationale

Concept files

1

0 records added/updated, plus 1 inactivated

Association files

9

9 records added/updated, plus 0 inactivated 

AttributeValue files

1654

1654 records added/updated, plus 0 inactivated

Description files (EN)

0

0 records added/updated, plus 0 inactivated

Description files (FR)

10851

105621 records added/updated, plus 289 inactivated

Description files (NL)

4019

4019 records added/updated, plus 0 inactivated

Description files (DE)

0

0 records added/updated, plus 0 inactivated

Language files (EN)

0

0 records added/updated, plus 0 inactivated

Language files (FR)

10987

10701records added/updated, plus 286 inactivated

Language (FR) context specific GP Refset

29

0 records added/updated, plus 29 inactivated

Language files (NL)

4045

4019 records added/updated, plus 26 inactivated

Language (NL) context specific GP Refset

0

0 record added/updated, plus 0 inactivated

Language files (DE)

0

0 records added/updated, plus 0 inactivated

Inferred Relationship files

9

0records added/updated, plus 9 inactivated

OWLExpression files

1

0 records added/updated, plus 1 inactivated

RefsetDescriptor files

0

0 records added, plus 0 updated

Translated Plant Materials Simple Refset

0

0 records added/updated, plus 0 inactivated 

Translated Edible Substances Simple Refset

0

0 records added/updated, plus 0 inactivated

Translated Animal Materials Simple Refset

0

0 records added/updated, plus 0 inactivated

Belgian GP refset files

42

15 records added/updated, plus 27 inactivated

Extended Map files (containing the new BE ICD-10 map content)

0

0 records added/updated, plus 0 inactivated

Belgian subset for medical problems in patient health records refset

18

8 records added/updated, plus 10inactivated

Belgian subset for Vaccination Simple Refset 

0

0 records added/updated, plus 0 inactivated

Belgian subset for Allergy Intolerance Causative Agent Drug Simple Refset

13

0 records added/updated, plus 13 inactivated

Belgian subset for Allergy Intolerance Causative Agent Non-Drug Simple Refset

1

0 records added/updated, plus 1 inactivated

Belgian subset for Allergy Intolerance Manifestation Simple Refset files

0

0 records added/updated, plus 0 inactivated

Identifier files

0

0 records added/updated, plus 0 inactivated

Relationship Concrete files

0

0 records added/updated, plus 0 inactivated

Subset For Nursing In Patient Health Records Simple Refset

15

9 records added/updated, plus 6 inactivated

Subset For Neonatology In Patient Health Records Simple Refset

0

0 records added/updated, plus 0 inactivated

Subset For Pulmonology In Patient Health Records Simple Refset

2

1 records added/updated, plus 1 inactivated

Subset For Rheumatology In Patient Health Records Simple Refset

4

2 records added/updated, plus 2 inactivated

Subset For Nephrology In Patient Health Records Simple Refset

0

0 records added/updated, plus 0 inactivated

Subset For Cardiology In Patient Health Records Simple Refset

0

0 records added/updated, plus 0 inactivated

Subset For Hematology In Patient Health Records Simple Refset

0

0 records added/updated, plus 0 inactivated

Subset For Infectious Diseases In Patient Health Records Simple Refset

0

0 records added/updated, plus 0 inactivated

Subset For Intensive Care In Patient Health Records Simple Refset

0

0 records added/updated, plus 0 inactivated

 SNOMED CT derived products  

 Reference sets

The release currently contains reference sets that serve one of the following 2 purposes :

- Reference sets to support the implementation of SNOMED CT in eHR software for clinical data entry/capture. These reference sets have a six-monthly release cycle.
- Reference sets to support data interoperability (mainly subsets representing value lists of BE FHIR profiles required by the Care Sets). These reference sets have a monthly release cycle.

A new version of a reference set is only published when there is a change compared to the previous version. Reference sets that do not require an update (meaning having no delta) are not republished despite their release cycle.

Here is a summary of the different existing refsets and their purpose:

Purpose

Subset

SCTID

Content

Clinical data entry

Belgian subset for medical problems in patient health records refset

40811000172108

Common disorders, findings and procedures found in general patient records.

Clinical data entry

Subset For Nursing In Patient Health Records Simple Refset

100941000172101

Common disorders, findings and procedures registered by nurses.

Clinical data entry

Subset For Neonatology In Patient Health Records Simple Refset

100971000172106

Common disorders and findings found in newborns.

Clinical data entry

Subset For Pulmonology In Patient Health Records Simple Refset

100961000172102

Common respiratory disorders and findings.

Clinical data entry

Subset For Rheumatology In Patient Health Records Simple Refset

100981000172109

Common rheumatic disorders and findings.

Clinical data entry

Subset For Nephrology In Patient Health Records Simple Refset

100951000172104

Common kidney-related disorders and findings.

Clinical data entry

Subset For Cardiology In Patient Health Records Simple Refset

131001000172104

Common cardiovascular disorders and findings.

Clinical data entry

Subset For Hematology In Patient Health Records Simple Refset

130991000172100

Common blood disorders and symptoms.

Clinical data entry

Subset For Infectious Diseases In Patient Health Records Simple Refset

130981000172103

Common infectious diseases caused by different pathogens.

Clinical data entry

Subset For Intensive Care In Patient Health Records Simple Refset

130971000172101

Common disorders and findings diagnosed in patients in intensive care.

Clinical data entry

Belgian GP Subset

721000172106

Common disorders, findings and procedures encountered by general practitioners in Belgium. This refset originated from a map between 3BT (Bilingual Biclassified Belgian Thesaurus) and SNOMED CT and has been enhanced thereafter.

Data interoperability (FHIR ValueSet)

Belgian subset for Allergy Intolerance Causative Agent Non-Drug Simple Refset

50851000172106

Common non-drug substances that cause allergies or intolerances.

Data interoperability (FHIR ValueSet)

Belgian subset for Allergy Intolerance Manifestation Simple Refset files

50861000172108

Common manifestations of allergies or intolerances. Monthly release cycle.

Data interoperability (FHIR ValueSet)

Belgian subset for Vaccination Simple Refset

50831000172102

Common vaccine products used in Belgium. Monthly release cycle.

Data interoperability (FHIR ValueSet)

Belgian subset for Allergy Intolerance Causative Agent Drug Simple Refset

50841000172109

Common drugs that cause allergies or intolerances. Monthly release cycle.

 New Reference sets

No new reference sets have been added to this release package.

 Changed Reference sets

The following reference sets were updated:

  • Subset For Nursing In Patient Health Records Simple Refset
  • Subset For Pulmonology In Patient Health Records Simple Refset
  • Belgian subset for medical problems in patient health records refset
  • Subset For Rheumatology In Patient Health Records Simple Refset


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.  

For the SNOMED CT Managed Service - Belgium Extension Release, the following Known Issues were identified, and agreed to be resolved in the next editing cycle:


IssuekeySummaryDescriptionPriorityKey

Technical notes

 Notice of changes to the Belgium Extension Release Schedule

As you may already know SNOMED International has transitioned to a monthly delivery schedule for the International Edition of SNOMED CT. The move towards more frequent releases of SNOMED CT realizes 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 both International and Managed Service release packages, including the Belgium 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 Belgian edition of SNOMED CT is also released monthly on the 15th of each month, except for January and August. The first monthly Belgian edition was published in November 2024.

Notice of changes to the BE Extension Release package

In line with the refined implementation of Annotations, we are updating all Extensions in order to align them with the updated version of the refsets in the International Edition Release package (which were first published in June 2024).

  • The languageCode field was specified as the two characters of ISO|-639-1 code for the language of the annotation text. The change includes support for specifying dialect when it is applicable by adhering to RFC 5646, which allows the combination of two characters of ISO 639-1 code and two uppercase letters of country code (ISO 3166) separated by a hyphen.  The changes apply to both the Member Annotations String Value Reference Set + Component Annotation String Value reference set:
    • The column "languageCode" has therefore been changed to "languageDialectCode".
      • Component Annotations (1292992004)
        • OLD:    id    effectiveTime    active    moduleId    refsetId    referencedComponentId    languageCode    typeId    value
        • NEW:   id    effectiveTime    active    moduleId    refsetId    referencedComponentId    languageDialectCode    typeId    value
      • Member Annotations (1292995002)
        • OLD:   id    effectiveTime    active    moduleId    refsetId    referencedComponentId    referencedMemberId    languageCode    typeId    value
        • NEW:  id    effectiveTime    active    moduleId    refsetId    referencedComponentId    referencedMemberId    languageDialectCode    typeId    value


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