Table Of Contents

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 organisation (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.

The SNOMED CT Irish Extension - packages these components for release every April and October, to be used with the latest SNOMED CT International Edition release.

The same content can be viewed online using the SNOMED CT browser, and eHealth Ireland website

Background

This document provides a summarized description of the content changes included in the October 2025 Production release of the SNOMED Clinical Terms^® Managed Service Ireland Extension package.

It will also include 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.

This Ireland Extension package is dependent upon, and should therefore be consumed in conjunction with the SNOMED CT® October 2025 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.

Content Development Activity

Summary

Content from the SNOMED CT® October 2025 International Edition release has been included, alongside additional components for use in Ireland. 

This extension contains concepts, relationships and reference sets for healthcare professionals. 

New and Updated Content

This is the 11th SNOMED CT Irish Edition Production release.

IE National Drug Extension

The National Drug Extension continues to be developed. This includes content development across the SNOMED International Drug Model and the Irish Drug Extension.

Please note that content development work is occurring in relation to medicinal products in the national SNOMED Irish Drug Extension.

This release contains concepts in the Pharmaceutical / biologic product (product), Qualifier value (qualifier value), and Substance (substance) hierarchies related to this ongoing work. Due to the volume of content, this will occur across several releases and release notes will be updated when this work reaches stability/maintenance levels. Ahead of this, please note that content in the Irish drug extension should be considered partial against the range of medicinal products available to be used in clinical care in Ireland.

Due to ongoing work drug content in this release has been excluded from final release classification. We recommend waiting until the November 2025 release to use medicinal product information, where an update will be provided in the release note.

Drug related additions since April 2025 in this release:

Table 1.0

IE Clinical Content

New and updated content

Concept statistics

The SNOMED Irish National Release Centre published 88 new concepts and 3 new reference sets for October 2025

New Reference sets

 Table 2.0. New reference sets

Reference Set changes

Table 3.0. Reference set changes

Table 3.1 Content Sent from Irish NRC to SNOMED International for promotion

Table 3.2 Content sent from Irish NRC to SNOMED International for authoring

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:

Resolved Issues

Resolved Issues are those where the resolution has been discussed and agreed, and has been implemented in time for this release. 

Advisory on Classification Results

Please note that this release package cannot be classified cleanly. Classification is an important quality assurance step that checks for logic errors and inconsistencies within the terminology. This is also reported in the chapter related to known issues.

As noted in the drugs extension section above, final release classification was not completed on drugs content in this release due to ongoing work. Please note that this does not affect clinical content in the release which has undergone routine Quality Assurance release processes.

Please consult the NRC for further guidance before using this release.

Changes for October 2025

Monthly Releases

The NRC is moving to monthly releases after October 2025 and as a result of preparation for this, please be aware that the 21st October 2025 release will contain "multiple/additional" effective times between April and October. 

Refset File Naming conventions

The new naming conventions for additional reference sets files have been applied to the Ireland Extension release package from the October 2025 IE Managed Service Release onwards. The new convention updates the file names to use RefsetID prefixes instead of the old human readable format, in order to improve maintainability and allow for machine reading of the file names. However, this convention will ONLY be applied to additional refsets, and not core refsets such as Language refset, Association refset, MRCM refset files, etc. (as these were considered to incur too high an impact on end users if the naming conventions were to be changed)

So, for example, in the October 2025 IE Managed Service Release the additional refset file names have changed from:

• “der2_Refset_AntimicrobialStewardshipPerformanceIndicatorMeasurementSystemApimsDataSetSimpleRefsetFull_IE1000220_20250421.txt”

  • to:

• “der2_Refset_74921000220101SimpleRefsetFull_IE1000220_20250421.txt”

The file name of the Association reference set has been aligned with the naming convention used in the International Edition. Please refer to the Terminology Release Advisory Group discussion page for details: Association Reference naming convention

• “der2_cRefset_AssociationReferenceFull_IE1000220_20250421.txt”

  • to:

• “der2_cRefset_AssociationFull_IE1000220_20250421.txt”

Notice of changes to the IE 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