SNOMED CT July 2020 International Edition - SNOMED International Release notes
Release Date | 20200731 |
Release Status | PRODUCTION RELEASE |
Document Version | 1.0 |
Introduction
Background
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.
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.
Purpose
This document provides a summarized description of the content changes included in the July 2020 release of SNOMED Clinical Terms® (SCT) International Release.
It also includes technical notes detailing the known content or technical issues where the root cause is understood, the fix has been discussed and agreed to, but has yet to be implemented.
The SNOMED International Release Notes are available alongside the July 2020 International Edition release.
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.
Audience
The audience includes National Release Centers, WHO-FIC release centers, vendors of electronic health records, terminology developers and managers who wish to have an understanding of changes that have been incorporated into the July 2020 International Edition release.
Content Development Activity
Summary
Continuous quality improvement and enhancement of existing content is an ongoing process undertaken by SNOMED International in preparation for every release. The July 2020 International Release has seen a continuation of the work driven by contributions from: Kaiser Permanente i.e. Convergent Medical Terminology (CMT), Global Medical Device Nomenclature Agency (GMDNA), Orphanet and other domain specific collaborations as well as requests received via the Content Request System (CRS).
Additionally quality improvement activities are advanced via project driven initiatives summarized below. Additional, work items impacting every release are updates to the SNOMED CT derived maps such as ICD-10 and ICD-O; details are included in these release notes.
Information about editorial decisions may be found in the SNOMED CT Editorial Guide; mapping guidance for ICD-10 can be found at this link https://confluence.ihtsdotools.org/display/DOCICD10
Important - Content Changes Introduced After the July 2020 Member Release, and before the July 2020 Production Release
Two additional concepts (plus their related components) were added to the July 2020 release after the Member release on 30 June 2020. They are therefore included in the final, Public release of the July 2020 International Edition.
The two new concepts are detailed elsewhere in these release notes however for information the new concepts are:
895231008|Not detected in pooled specimen (qualifier value)|
890195008|International Health Terminology Standards Development Organisation Global Patient Set module (core metadata concept)|
Inactivation reason: Limited/WAS_A
Inactivation reason of LIMITED/WAS_A is not allowed for any new content inactivations after the July 2018 release. The WAS_A association refset has not been updated thereafter.
At the Editorial Advisory Group meeting in April 2019, agreement was reached to discontinue the maintenance of WAS_A relationships when inactivating concepts that have a historical association to an inactive concept. When changes are made to a historical relationship for a concept that was previously inactivated using WAS_A, effort will be made to assign a new historical relationship that facilitates traceability of the concept (e.g. DUPLICATE or AMBIGUOUS) as opposed to NON-CONFORMANCE TO EDITORIAL POLICY.
Existing WAS_A relationships will be inactivated in a future release once a plan for batch reassignment of historical relationships has been developed. Until then, SNOMED International will not continue to use or maintain WAS_A relationships.
COVID-19
An INTERIM International Edition Release was produced in March 2020 as part of the ongoing global effort to tackle the Coronavirus outbreak and included the updated Coronavirus descriptions for Members and implementers.
New components March 2020 Interim release |
|---|
840544004 3947197012 Suspected disease caused by severe acute respiratory coronavirus 2 (situation) 840544004 3947195016 Suspected disease caused by SARS-CoV-2 840544004 3947196015 Suspected disease caused by severe acute respiratory coronavirus 2 840544004 3950926016 Suspected COVID-19 |
840534001 3947192018 Severe acute respiratory syndrome coronavirus 2 vaccination (procedure) 840534001 3947193011 SARS-CoV-2 vaccination 840534001 3947194017 Severe acute respiratory syndrome coronavirus 2 vaccination 840534001 3950925017 COVID-19 vaccination |
840533007 3947189017 Severe acute respiratory syndrome coronavirus 2 (organism) 840533007 3947190014 SARS-CoV-2 840533007 3947191013 Severe acute respiratory syndrome coronavirus 2 |
840546002 3947186012 Exposure to severe acute respiratory syndrome coronavirus 2 (event) 840546002 3947187015 Exposure to SARS-CoV-2 840546002 3947188013 Exposure to severe acute respiratory syndrome coronavirus 2 |
840539006 3947183016 Disease caused by severe acute respiratory syndrome coronavirus 2 (disorder) 840539006 3947184010 Disease caused by severe acute respiratory syndrome coronavirus 2 840539006 3947185011 COVID-19 |
840536004 3947180018 Antigen of severe acute respiratory syndrome coronavirus 2 (substance) 840536004 3947181019 Antigen of severe acute respiratory syndrome coronavirus 2 840536004 3947182014 Antigen of SARS-CoV-2 |
840535000 3947177019 Antibody to severe acute respiratory syndrome coronavirus 2 (substance) 840535000 3947178012 Antibody to severe acute respiratory syndrome coronavirus 2 840535000 3947179016 Antibody to SARS-CoV-2 |
A further set of new concepts have been added for the July 2020 release
New concepts July 2020 release |
|---|
Clinical finding hierarchy: 138389411000119105| Acute bronchitis caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 870590002| Acute hypoxemic respiratory failure due to disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 870589006| Acute kidney injury due to disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 674814021000119106| Acute respiratory distress syndrome due to disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 189486241000119100| Asymptomatic Severe acute respiratory syndrome coronavirus 2 infection (finding) 870577009| At increased risk of exposure to Severe acute respiratory syndrome coronavirus 2 (finding) 119731000146105| Cardiomyopathy due to disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 119741000146102| Conjunctivitis due to disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 119981000146107| Dyspnea caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 1240561000000108| Encephalopathy due to disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 119751000146104| Fever caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 1240541000000107| Infection of upper respiratory tract caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 880529761000119102| Lower respiratory infection caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 866151004| Lymphocytopenia due to Severe acute respiratory syndrome coronavirus 2 (disorder) 1240531000000103| Myocarditis due to disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 1240521000000100| Otitis media due to disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 882784691000119100| Pneumonia caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 870591003| Rhabdomyolysis due to disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 870588003| Sepsis due to disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder) 1240581000000104| Severe acute respiratory syndrome coronavirus 2 detected (finding) 1240591000000102| Severe acute respiratory syndrome coronavirus 2 not detected (finding) 866152006| Thrombocytopenia due to Severe acute respiratory syndrome coronavirus 2 (disorder) |
Observable entity hierarchy: 871555000| Detection of ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 (observable entity) 871559006| Detection of ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 in bronchoalveolar lavage fluid (observable entity) 871556004| Detection of ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 in nasopharyngeal swab (observable entity) 871557008| Detection of ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 in oropharyngeal swab (observable entity) 871558003| Detection of ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 in sputum (observable entity) 871560001| Detection of ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 using polymerase chain reaction (observable entity) 871562009| Detection of Severe acute respiratory syndrome coronavirus 2 (observable entity) 871552002| Detection of Severe acute respiratory syndrome coronavirus 2 antibody (observable entity) 871553007| Detection of Severe acute respiratory syndrome coronavirus 2 antigen (observable entity) 1240461000000109| Measurement of Severe acute respiratory syndrome coronavirus 2 antibody (observable entity) 1240471000000102| Measurement of Severe acute respiratory syndrome coronavirus 2 antigen (observable entity) |
Situation with explicit context hierarchy: 688232241000119100| Disease caused by Severe acute respiratory syndrome coronavirus 2 absent (situation) 292508471000119105| History of disease caused by Severe acute respiratory syndrome coronavirus 2 (situation) |
Specimen hierarchy: 461911000124106| Swab specimen from oropharynx (specimen) |
Substance hierarchy: 870361009| Immunoglobulin G antibody to Severe acute respiratory syndrome coronavirus 2 (substance) 870362002| Immunoglobulin M antibody to Severe acute respiratory syndrome coronavirus 2 (substance) 1240411000000107| Ribonucleic acid of Severe acute respiratory syndrome coronavirus 2 (substance) |
Qualifier value hierarchy: 895231008|Not detected in pooled specimen (qualifier value)| |
Updates about content relating to COVID-19 can be found here SNOMED CT COVID-19 Related Content
Any concepts in scope for SNOMED CT to ICD-10 mapping have been mapped and adhere to the World Health Organization current guidelines.
Content Quality Improvement
SCT Statistics | |
|---|---|
Domain | #New concepts |
SNOMED CT Concept (SNOMED RT+CTV3) | 3876 |
Body structure (body structure) | 306 |
Clinical finding (finding) | 2064 |
Event (event) | 4 |
Environment or geographical location (environment / location) | 19 |
Observable entity (observable entity) | 117 |
Organism (organism) | 135 |
Pharmaceutical / biologic product (product) | 441 |
Physical object (physical object) | 89 |
Procedure (procedure) | 299 |
Qualifier value (qualifier value) | 66 |
Record artifact (record artifact) | 2 |
Social context (social concept)| | 8 |
Situation with explicit context (situation) | 129 |
Specimen (specimen) | 8 |
Substance (substance) | 137 |
Staging and scales (staging scale) | 33 |
SNOMED CT Model Component (metadata) | 19 |
SCT Statistics for July 2020 Release | |
|---|---|
| #total |
Newly inactivated concepts | 2073 |
Newly reactivated concepts | 13 |
Changed Fully Specified Name | 986 |
Inactivated descriptions (synonym only) | 1434 |
New descriptions (synonym only) on existing concepts | 2251 |
Reactivated description (synonym only) | 15 |
New inferred relationships | 4088 |
Changed inferred relationships | 10766 |
Changed definitional status | 1607 |
Body structure
New body structure concepts: 306
Completion of the revision of hierarchical relationships provides stable anatomy content and improves the quality of classification results in other hierarchies.
The plan is to implement the new anatomy concept model over forthcoming releases. There are approximately 35,000 anatomy concepts to be modeled by different types of 'part of' relationships. The new model will enable the automatic generation of hierarchies to further improve quality and consistency. The concept model for over 14,000 structure concepts has been tested by batch import of axioms into the authoring platform. In order to gather feedback and evaluate the potential impact on the classification to content in extensions, a demonstration release of the anatomy model changes is planned for January 2021.
Abdomen/Pelvis
Updated modelling for diagnostic imaging procedures related to the changes for abdomen terminology, e.g. CT, MRI, SPECT CT have been implemented.
The notion of ‘abdomen’ in clinical practice can vary between different specialties and circumstances; for example, ‘abdomen’ in natural language can be used to refer to, but is not limited to, the following concepts:
• Abdominopelvic cavity
• Abdominopelvic cavity excluding the true pelvic cavity (Abdomen proper cavity)
• Abdominopelvic cavity and/or content (Intra-abdominopelvic structure)
• Intra-abdominopelvic structure excluding intra-pelvic structure of true pelvis
• Intra-abdominopelvic structure and/or anterior abdominal wall
• Intra-abdominopelvic structure and/or anterior abdominal wall, excluding intra-pelvic structure of true pelvis (Abdomen proper)
• Abdominal segment of trunk
• Abdominal cross-sectional segment of trunk
SNOMED International considers the most commonly used clinical variant referred to as ‘abdomen’ to be 818983003 |Structure of abdominopelvic cavity and/or content of abdominopelvic cavity and/or anterior abdominal wall (body structure)|, which in SNOMED CT is now the only concept using ‘Abdomen’ as a synonym. Revision of the inguinal region, anal structures and vaginal structures have been implemented in order to address some historical sub-optimal classification results.
Further detail can be found at https://docs.google.com/document/d/1gxkcEYf89eJl0RJG8-S2w4zOdpF8R2sn5SHx7InWxZI/edit?usp=sharing
Coronary artery
Updated left coronary arteries following the pattern for branches of blood vessels.
Cardiac ventricle
Updated the 17 segments of left cardiac ventricle and eliminated the term 'posterior' from anatomy according to the standard from the American Heart Association.
Jaw region
The missing relationship between jaw and tooth that was reported by the Dentistry Clinical Reference Group has been resolved.
Peripheral artery
The peripheral arterial anatomy hierarchy has been augmented to improve a number of dependant sections including that of peripheral arterial diseases. The update has addressed over 100 incorrect classification results.
Mediastinum
Disorders of mediastinum are modeled by a new anatomy concept |Structure of space and/or soft connective tissue within mediastinal cavity (body structure)|. This has addressed nearly 300 incorrect classifications, such as myocarditis being classified as a type of mediastinitis.
Planned revision of Cell hierarchy in the January 2021 release
The content under 4421005 |Cell structure (cell structure)| will be updated according to the SEP model and description patterns. Descendants of 362837007 |Entire cell (cell)| will be updated to include the word ‘entire’ in all descriptions. The semantic tag ‘(cell)’ will be changed to ‘(cell structure)’. Descriptions for the rest of the concepts will be updated to include the word ‘structure’.
This improvement will reduce the potential misuse of cell concepts.
Please contact info@snomed.org with any inquiries or to submit feedback.
Reference set updates
Updated and validated release file for the lateralizable body structure reference set.
Updated and validated release files for the SEP refsets.
Clinical finding
New concepts added for clinical finding hierarchy: 2064
Quality Initiative
The Quality Initiative (QI) project is the implementation of the Quality Strategy. After a successful pilot project for the July 2018 release the next stage has been implemented for subsequent releases including July 2020.
Quality improvement tasks were deployed to improve internal structural consistency and ensure compliance with editorial policy related to the stated modeling of content. Additionally, correction or addition of defining relationships was carried out to accurately reflect current clinical knowledge and ensure the semantic reliability of descriptions associated with a concept.
Total count of changes for the QI project:
Stated: A total of 6835 concepts had changes made to the Stated relationships in the model.
Inferred: A total of 10731 concepts affected by inferred changes.
QI Project focus for July 2020 release (work has begun or been completed) | |
|---|---|
1806006|Eruption (morphologic abnormality)| | 41010001|Maturation defect (morphologic abnormality)| |
708528005|Narrowing (morphologic abnormality)| | 107666005|Fluid disturbance (morphologic abnormality)| |
112639008|Protrusion (morphologic abnormality)| | 79644001|Pigment alteration (morphologic abnormality)| |
6574001|Necrosis (morphologic abnormality)| | 449735000|Structural change due to ischemia (morphologic abnormality)| |
708530007 |Obstructive morphology (morphologic abnormality)| | 5294002 |Developmental disorder (disorder)| (excluding congenital disorders) |
367651003|Malignant neoplasm of primary, secondary, or uncertain origin (morphologic abnormality)| | 125673005|Traumatic dislocation (morphologic abnormality) |
Revision of 129156001|Traumatic dislocation of joint (disorder)|
Traumatic dislocation concepts have been remodeled according to the new representation using DUE TO "traumatic event". This work was commenced in the January 2020 release and has been completed for the July 2020 release.
Birth injury
These concepts have been remodeled according to the new representation using DUE TO 'traumatic event' to be consistent with the new traumatic injury model.
Traumatic brain injury
Traumatic brain injury concepts with specified concrete ranges relating to 'loss of consciousness' have been inactivated due to their limited clinical value and lack of historical usage.
Revision of Spinal Cord Syndrome
A new concept 840721004| Incomplete spinal cord syndrome (disorder) has been created as a grouper parent to the four major subtypes of this syndrome:
282785008 |Anterior cord syndrome (disorder)|
27982003|Brown-Séquard syndrome (disorder)|
282786009 |Posterior cord syndrome (disorder)|
282787000 |Central cord syndrome (disorder)|
In prior releases these syndromes had been modeled with an ASSOCIATED MORPHOLOGY = 19130008|Traumatic abnormality (morphologic abnormality)|; however, these syndromes may present due to non-traumatic etiologies such as space filling lesions (tumors, etc.) or vascular compromise (occlusions, ruptures, etc.). These syndromes have been remodeled with ASSOCIATED MORPHOLOGY = 52988006|Lesion (morphologic abnormality)|.
Incomplete cord syndromes with a traumatic cause have been remodeled to specifically represent 773760007 |Traumatic event (event)| as the DUE TO value as well as any other relationships to describe associated disorders (e.g. fractures or dislocations).
Malignant neoplasm
The content relating to Primary and secondary malignant neoplasms excluding Malignant tumours of lymphoid, hemopoietic and related tissues have been updated in line with the QI project objectives. This has resulted in an increase in sufficiently defined content and minor movement of previously incorrectly placed content into their appropriate hierarchies. Malignant tumours of lymphoid, hemopoietic and related tissue concepts will be addressed in the next release cycle along with any residual malignant neoplasm content.
Update Allergy to substance (finding)
As part of the QI project review of the 419199007 |Allergy to substance (finding)| sub-hierarchy and per the Allergies Clinical Reference Group recommendation, the concepts in this sub-hierarchy that represent allergy to "role groupers" and "Structure + role groupers" are being inactivated starting from the July 2020 release. Examples of these concepts are provided below:
Content Tracker Project Updates
Work on hold on the following Content Project:
IHTSDO- 393 Diabetes Complications - The Diabetes Project Group comprises practicing clinicians. As a result of the COVID-19 pandemic the majority of the participating clinicians have been drafted into supporting the response to this health care crisis. Consequently this project has been put on temporary hold until the pandemic is under control and healthcare staff are able to return to their normal duties.
Work completed for the following Content Project:
IHTSDO-1157 Distinction between Pain and Tenderness. Improvement in the modeling of the Tenderness (finding) sub-hierarchy.
Improve modeling for 404177007|Angioedema and/or urticaria (disorder)| and descendants
Remodel 404177007|Angioedema and/or urticaria (disorder)| and descendants.
New morphology concept added 846575004 |Angioedema (morphologic abnormality)|
Changes for 'On Examination' and 'Complaining of' concepts
The 'on examination' and 'complaining of' content is being returned to the UK as part of the work for the January 2021 release. As part of this work, where no suitable replacement concept existed (without the examination or complaint component of the meaning) and the clinical meaning met editorial guidelines new concepts were added. This work was done over the January 2020 and July 2020 releases. For the July 2020 release this included the addition of 230 new concepts.
Update 17602002 Amyloidosis (disorder) and descendants
The modeling and terming of many amyloidosis disorder concepts were updated in the 17602002 Amyloidosis (disorder) sub-hierarchy.
Reactivation of 419952004 |Dermoid cyst (disorder)|
Existing concepts using the fully specified name "Cystic dermoid choristoma" have been inactivated and replaced with new concepts using the fully specified name "Dermoid cyst of X".
These concepts have all been inactivated:
441459009 |Cystic dermoid choristoma (disorder)| and all subtypes
416529009 |Cystic dermoid choristoma (morphologic abnormality)|
417137001 |Dermoid choristoma (morphologic abnormality)|
Rename FSN for concepts using 'Ecstasy' to Methylenedioxymethamphetamine
Ecstasy is not synonymous with Methylenedioxymethamphetamine (MDMA). Where “Ecstasy” is used in FSN and Causative agent is MDMA the concept has been replaced with a new or existing concept with FSN that contains MDMA. When “Ecstasy type drug” is used in FSN, regardless of causative agent the concept is replaced with a concept with FSN for “Amfetamine and amfetamine derivative (substance).”
Remodel 397803000 |Impotence (disorder) and descendants
397803000 |Impotence (disorder) has been inactivated and replaced with a new concept 860914002 |Erectile dysfunction (disorder). Subtype concepts that used the word 'impotence' have also been replaced with concepts that use the term 'erectile dysfunction.'
New concept 840358001 |High body weight (finding)| and realignment of subtypes
A new concept 840358001 |High body weight (finding)| has been added and has 2 subtypes that are siblings:
414915002 |Obese (finding)|
238131007 |Overweight (finding)|
The two latter findings of 'Obese' and 'Overweight' are mutually exclusive terms in the classification of BMI.
New concepts - Mental health
2 new concepts have been added after liaison with the Mental and Behavioural Health Clinical Reference Group:
'Depressive episode' has been removed as a synonym on 35489007 |Depressive disorder (disorder)|.
New concept has been added 871840004 |Episode of depression (finding)|.
New concept added: 833326008 |Cortical vascular dementia (disorder)|
Notice: 'Co-occurrent and due to' pattern: During the implementation of the new Description Logic features, a conflict was uncovered between the modeling of 'Co-occurrent and due to' and General Concept Inclusions (GCIs). This has resulted in the need to reconsider the modeling of "Co-occurrent and due to' and update the Editorial Guide for this area. The Editorial Guide and all concepts that are currently modeled as 'Co-occurrent and due to' will be updated over future release cycles. |
|---|
Convergent Medical Terminologies (CMT)
New CMT concepts: 714
Injury - 162 concepts added.
Ophthalmology - 552 concepts added.
Procedure
New concepts for procedure hierarchy: 299
Implantation and Insertion procedures
Work continues on content tracker IHTSDO-175. There are ongoing structural changes for the Procedure concepts related to the content tracker. Work on this project will continue for future releases after July 2020.
Content Inactivation - Anesthesia
These concepts have been inactivated from the International release and moved to the US extension:
67902001 |Anesthesia for a normal healthy patient (procedure)|
23102000 |Anesthesia for a patient with mild systemic disease (procedure)|
22211001 |Anesthesia for a patient with severe systemic disease (procedure)|
112989003 |Anesthesia for a moribund patient requiring operation (procedure)|
71191009 |Anesthesia for a patient with severe systemic disease, life threatening (procedure)|
Content Inactivation - Monitoring
These concepts have been inactivated from the International release and moved to the UK extension:
391023009|Osteoporosis - no treatment (regime/therapy)|
391030003|Osteoporosis - no treatment response (regime/therapy)|
391028000|Osteoporosis - treatment response (regime/therapy)|
391003008|Osteoporosis monitoring administration (regime/therapy)|
391004002|Attends osteoporosis monitoring (regime/therapy)|
391006000|Osteoporosis monitoring default (regime/therapy)|
391012005|Osteoporosis monitoring deleted (regime/therapy)|
391007009|Osteoporosis monitoring first letter (regime/therapy)|
391008004|Osteoporosis monitoring second letter (regime/therapy)|
391011003|Osteoporosis monitoring telephone invitation (regime/therapy)|
391009007|Osteoporosis monitoring third letter (regime/therapy)|
391010002|Osteoporosis monitoring verbal invitation (regime/therapy)|
Evaluation Procedure
New evaluation procedure concepts - 10 (respiratory procedures, specimen processing and laboratory panels).
Concept inaction - 13 (inactivated due to duplication or ambiguity).
Collaboration/Harmonization Projects
Orphanet
Working in collaboration with Orphanet (http://www.orpha.net/consor/cgi-bin/index.php), creation of new concepts for the original set of prioritized rare diseases has been completed. The alpha release is now available for feedback, for more information please see April 2020 SNOMED CT Orphanet Simple Map package ALPHA release available
All of the concepts added for the Orphanet project have been mapped to ICD-10.
ICD-11 Update
A total of 593 new concepts were added for the July 2020 release.
Global Medical Device Nomenclature Agency (GMDNA)
62 new device concepts were added to the physical object hierarchy for GMDN.
For the GMDN mapping equivalence tables:
62 new concepts have been added to in scope and mapped.
156 concepts have been modified and removed from the mapping tool as out of scope.
95 concepts have been deemed obsolete and removed from the mapping tool and flagged as out of scope.
ICD-O-3.2 Update
A full Impact analysis of both updating the existing SNOMED CT content and updating the current ICD-O-3.1 map has been carried out. In particular this relates to changes to the 400177003 |Neoplasm and/or hamartoma (morphologic abnormality)| sub-hierarchy in SNOMED CT. The impact analysis utilized the final IACR ICD-O-3.2 (WHO IARC) morphology code listing and the new pdf changes documents on their website (http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577).
For the July 2020 release only minor changes have been made, and 14 new morphologies have been added to the 108369006 |Neoplasm (morphologic abnormality)| sub-hierarchy.
Note - The published maps to ICD-O-3.1 are being updated only for maintenance purposes for the July 2020 release. The maps to ICD-O-3.2 are out of scope for the July 2020 release and are planned for a future release.
Event
New concepts added: 4
Qualifier Value
New concepts added: 65
Occupation
Concepts representing "other" occupations e.g. 79445009 |Other clerk (occupation)| have been inactivated as ambiguous as these represent classification constructs.
Situation with explicit context
New concepts added: 129
Physical object
New concepts added: 89
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