Table Of Contents

Introduction

Background

SNOMED CT 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 2026 release of SNOMED Clinical Terms^® (SCT) International Edition.

It also includes 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 2026 International Edition.

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.

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 2026 International Edition.

Please note, you may have to register for a user account in order to access the links included in these release notes.

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 2026 International Edition 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 here.

Quality Assurance

Revision of Clinical Findings Defined by Ethanol

A review has been undertaken for more than 100 concepts where the causative agent is 419442005 |Ethanol (substance)|.

Changes made:

• FSNs updated to include “ethanol” to align with editorial guidelines and substance reference sources

• “Alcohol” used as the Preferred Term, reflecting common clinical usage

• “Ethyl alcohol” has been retained or added as a synonym where appropriate

This approach will be applied to newly created concepts, and the Editorial Guide will be updated accordingly. Further information is available in this briefing note.

Inactivation of Descriptions with (clinical)

44 disorder concepts with the inclusion of a description with "(clinical)" in it, for example:

• 109988003 |Histiocytic sarcoma (disorder)| with PT “Histiocytic sarcoma (clinical)”

have been reviewed and the description with (clinical) has been inactivated with reason Nonconformance to editorial policy.

Number of concepts edited (approx): 44

Update Descriptions Sulfate/Sulphate

The word sulfate has a GB alternative of sulphate. An acceptable synonym (not acceptable US) has been added for 429 concepts.

Awaiting <x> (finding) Inactivations

The patterns “Awaiting <procedure> (finding)" and “<Procedure> awaited (finding)” are administrative situations therefore out of scope for the International Edition release. Eleven concepts have been inactivated with the reason: 723277005 |Nonconformance to editorial policy component (foundation metadata concept)|. There is no historical association value.

Body Structure 

New Content Cell Structure

Chromosome bands at the 400, 550, and 850 band resolution have been added as cell structures. These concepts will be used as ancestors for the location of genes being added to SNOMED CT as well as to define chromosomal abnormality concepts such as 1003380001 |6q16 microdeletion syndrome(disorder)|

Further information is available in this briefing note.

Number of concepts edited (approx): 400

SEP and Laterality Anatomy Reference Sets

The release file for the lateralizable body structure reference set has been updated and validated.

The release file for the SEP reference set has been updated and validated.

Clinical Finding

Inactivation of 309794002 |Finding of body product (finding)

309794002 |Finding of body product (finding) and defining concept 364684009 |Body product observable (observable entity)| have been inactivated with reason Nonconformance to editorial policy.

Observable Entity

Inactivation of Laboratory Observable Concepts

Three vague and/or not clinically useful laboratory observable concepts have been inactivated:

• 14237002|Feature of entity (observable entity)|

• 396277003 |Fluid observable (observable entity)|

• 106090003|Body fluid property (observable entity)|

The definition for eight observable entity concepts have been updated to include modeling:

• 85015001|Blood viscosity (observable entity)|

• 401156005|Plasma osmolality (observable entity)

• 56953008|Osmolality (observable entity)

• 167886001|Synovial fluid viscosity (observable entity)

• 27327002||Hydrogen ion concentration (observable entity)

• 441389003|Viscosity of exudate (observable entity)

• 78949001|Viscosity (observable entity)

• 703421000|Temperature (observable entity)

Qualifier Value

Inactivation of 303109001|Pathogeneses (qualifier value)| and Descendants

303109001|Pathogeneses (qualifier value)| and descendants has been inactivated with reason Nonconformance to editorial policy.

Two concepts from the subhierarchy:

• 11214006 |Reactive (qualifier value)|

• 255386009 |Immune (qualifier value)|

remain active under an appropriate parent. Please see this informational briefing note for more information.

Number of concepts edited (approx): 20

Concept inactivations: 19

Collaboration/Harmonization Agreements

Convergent Medical Terminology (CMT)

9 new CMT disorder concepts have been added for the July 2026 International Edition release.

Orphanet

Working in collaboration with Orphanet efforts are ongoing to update rare disease concepts in SNOMED CT to maintain alignment with Orphanet for the annual update of the SNOMED CT to Orphanet Maps. This map is at disorder level. In scope content has been annotated with attribution to Inserm Orphanet.

All of the concepts added for the Orphanet project have been mapped to ICD-10.

International League Against Epilepsy (ILAE)

In line with approved harmonized terminology, this project is working on alignment including restructuring to update the hierarchy  << 313307000 |Epileptic seizure (finding)|.

Further information about this collaboration is available here.

Internal Quality Improvement

Machine Readable Concept Model (MRCM) Changes

There are changes for the MRCM in the July 2026 International Edition release, new attributes added for modeling devices:

• 1399115004 |Is receptacle for (attribute)|

• 1399113006 |Has additive (attribute)|

• 1399114000 |Has separator (attribute)|

Future changes that are currently in progress can be viewed via the MRCM Daily Build Browser

Please see Early Visibility Release Notifications for future planned changes to MRCM.

Annotation Reference Set

The addition of content for the Annotations refset was commenced in the July 2024 International Edition release and is ongoing for attribution of in scope content that is part of a collaboration agreement. Where content with attribution no longer falls into scope for a collaboration agreement, the attribution has been inactivated.

SNOMED CT derived products

SNOMED CT - ICD-10 map

The SNOMED CT to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (© World Health Organization 1994) 2016 Version map (SNOMED CT to ICD-10 Map) is included in the SNOMED CT International Edition as a Baseline. The SNOMED CT to ICD-10 Map was created to support the epidemiological, statistical and administrative reporting needs of SNOMED International member countries and WHO Collaborating Centers.

The SNOMED CT to ICD-10 Map is released in Release Format 2 (RF2) only. It is located in the file der2_iisssccRefset_ExtendedMapFull_INT_20200731.txt, which is in the Map folder under Refset, in each of the three RF2 Release Type folders. 

The SNOMED CT to ICD-10 Map is released as Refset 447562003 |SNOMED CT to ICD-10 extended map (foundation metadata concept).

The ICD-10 Mapping Technical Guide (including exemplars) is here.

Content Development Activity Summary

The map is a directed set of relationships from SNOMED CT source concepts to ICD-10 target classification codes.  The SNOMED CT source domains for the map are constrained to subtypes of 404684003 |Clinical finding (finding)|, 272379006 |Event (event)|, and 243796009 |Situation with explicit context (situation)|. The target classification used is the ICD-10 WHO version 2016 (https://icd.who.int/browse10/2016/en#/).

The map provided for this release has been updated and represents a complete map from the July 2026 release of the SNOMED CT International Edition to the ICD-10 WHO version 2016.

This includes:

Mapped content for July 2026 release

• Addition of 84 new mapped concepts (includes 1 reactivation)

• Updates to 58 existing mapped concepts

• Retirement of 54 mapped concepts

The SNOMED CT to ICD-O morphology map has 2 new mapped concepts for this release.

We welcome feedback on any issues that users may detect when deploying the map. Issues can be reported to mapping@snomed.org.

SNOMED CT to OWL conversion and classification

The repository containing the toolkit enabling simple SNOMED CT to OWL conversion and classification can be found here, including documentation on its use: https://github.com/IHTSDO/snomed-owl-toolkit

Please contact SNOMED International at support@snomed.org if you would like to provide any feedback on ways to extend and improve the new toolkit.

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 time within the new monthly editing cycles, 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 current SNOMED CT International Edition, the following Known Issues were identified, and agreed to be resolved in future editing cycles:

https://snomed.atlassian.net/issues/?jql=project%20%3D%20ISRS%20AND%20%22product%20release%20date%22%20%3D%20%222026-06-01%22%20AND%20status%20%3D%20%22Known%20Issue%22%20AND%20%22snomed%20ct%20product%22%20%3D%20%22SNOMED%20CT%20International%20edition%22%20ORDER%20BY%20priority%20DESC%2C%20updated%20DESC%20%20%20%20%20%20%20%20%20%20%20%20%20%20

Resolved Issues

Resolved issues are Known Issues which were not fixed as part of the previous release lifecycle, but which have now been resolved in the latest release.  They can also be issues found during testing of the current release, which were resolved before the final deployment of the Production release.  Finally they can be issues which were reported or found during the testing phase, but which have been closed without any action taken.  

The Resolved Issues for the current SNOMED CT International Edition can be found here:

https://snomed.atlassian.net/issues/?jql=project%20%3D%20ISRS%20AND%20%22product%20release%20date%22%20%3D%20%222026-07-01%22%20AND%20status%20%3D%20%22Known%20Issue%22%20AND%20%22snomed%20ct%20product%22%20%3D%20%22SNOMED%20CT%20International%20edition%22%20ORDER%20BY%20priority%20DESC%2C%20updated%20DESC%20%20%20%20%20%20%20%20%20%20%20%20%20%20

Technical updates

RF2 package format

The RF2 package convention dictates that all relevant files are included, regardless of whether or not there is content to be included in each release.  Therefore, the package contains a mixture of files which contain both header rows and content data, and files that (intentionally) include only header records.  The reason that these "empty" files are included in the package is to draw a clear distinction between:

1. ...files that have been deprecated (and therefore removed from the package completely), due to the content no longer being relevant to RF2 in future releases 

2. ...files that happen to contain no data in this particular release (and are therefore included in the package with just a header record), but are still relevant to RF2, and could therefore contain content in future releases.

This allows users to easily distinguish between the two scenarios, as otherwise if files in option 2 were left out of the package it could be interpreted as an error, rather than an intentional lack of content in that release.

Increase to the maximum length of Description Types

In line with the agreed Transition plan signed off by the Member Forum, the changes to increase the maximum allowed length of Descriptions have been implemented in the July 2026 International Edition.

• As highlighted in earlier communications, with the exception of the Medicinal Product hierarchy, the vast majority of descriptions will remain at their current length, well below 255 characters.

• The original plan was to increase several International Edition descriptions to around 330 characters in length. However, these still require further investigation, and so these updates will be postponed until the analysis is complete. They will then be deployed in a subsequent International release (currently planned for August 2026), once they are ready for publication.

• The only change, then, for this July 2026 International release, was to transition the International Edition to the new Description Length Limit. This simply involved an update to the DescriptionType files (eg. der2_ciRefset_DescriptionTypeSnapshot_INT_20260701.txt), to update the “descriptionLength” fields from 255 to 4096.

A community consultation was completed to solicit feedback on the proposal to increase the size limits of SNOMED CT concept descriptions to 4096 from the current limit of 255 characters. While this change does not represent a modification of the existing specification, there is a potential for it to be disruptive to implementers who have coded fixed length limits into their systems.  

For further information please read the latest Q&A blog post for details of the changes, the potential benefits, and the issues that were considered in preparation for the transition in July 2026. Please see here for the original conclusion of the plan to increase the limit of characters allowed in Descriptions.

For any questions please contact SNOMED International at release@snomed.org.

Improvements to the RefsetDescriptor file

There are a handful of Refset patterns that have been part of the Release file specification for some time now, but which have yet to be utilised and therefore have refsetDescriptor records assigned to them. In order to prevent any barriers for any Member country wishing to adopt one or more of these refsets, we are now including relevant refsetDescriptor records in the International Edition. Adding these refsetDescriptors now does not necessitate use of the refsets, but is simply a forward-looking strategy to enabling efficient refset usage where required in future. Establishing shared, authoritative refsetDescriptors in the International Edition ensures that as more members adopt these refsets, they inherit a consistent foundation rather than having to resolve the gap themselves.

RefsetDescriptor records have therefore been added to the International Edition for the following refsets:

• 900000000000513000 |Simple query specification reference set (foundation metadata concept)|

• 900000000000529008 |SIMILAR TO association reference set|

• 609430003 |Concept model reference set|

• 733613001 |Intensional definition reference set|

• 733614007 |Expansion history reference set|

ADVANCED NOTICE: Deprecation of the CNC Indicators from the International Edition

Following on from the announcements in late 2024 and early 2025, the plan to deprecate the Concept Non Current Indicators from the International Edition release is as follows, and implementation was started in the January 2026 International Edition release:

Early visibility of impending changes in Monthly International Edition releases

Please see the 2026 Early Visibility Notices for details of forthcoming changes.