In the Result Observation (V3) template there is an inconsistency between the code and value elements. The code element SHOULD be LOINC. However if value is a CD  the value SHOULD be SNOMED-CT. The problem is that many LOINC observation codes with a scale type of Ordinal or Nominal are bound to answer lists which contain at least one LOINC term.

For example see LOINC code 87955-1. The answer list contains a mix of SNOMED CT and non-SNOMED CT terms. The best practice is to set the value element to a SNOMED CT code only if that's the best answer. But if a LOINC term is a better match then that should be used instead.

I recommend we change conformance statement 1198-32610 as follows.

"If Observation/value is a CD (xsi:type="CD") the value SHOULD be SNOMED-CT or LOINC (CONF:1198-32610)."