The current definition for FHIR STU 3 version 3.1.0 has the following logical definition for US Core Condition Codes:

• 160245001No current problems or disability
• Include codes from http://snomed.info/sct where concept is-a 404684003 (Clinical finding (finding))
• Include codes from http://snomed.info/sct where concept is-a 243796009 (Context-dependent category)
• Include all codes defined in http://hl7.org/fhir/sid/icd-10-cm
• Include all codes defined in http://hl7.org/fhir/sid/icd-9-cm

Requested Change:

Please change:

• Include codes from http://snomed.info/sct where concept is-a 243796009 (Context-dependent category)

To be:

• Include codes from http://snomed.info/sct where concept is-a 413350009 (Finding with explicit context (situation))
• Include codes from http://snomed.info/sct where concept is-a 182985004 (Response to treatment (situation))

Justification:

The current logical definition includes all concepts in the 243796009 | Situation with explicit context (situation) hierarchy.  There are concepts such as 129125009 |  Procedure with explicit context (situation) and 57177007 | Family history with explicit context (situation) in this hierarchy that should not be included in as a clinical condition for the subject of the medical record. Procedures belong in another section and Family History concepts apply to family members that are not the subject of the medical record (i.e. father, mother, etc.). Since this is an intentional value set definition, the user must be able to extract the components of the value set using transitive closure, so specifying a sub-domain as part of the logical definition is appropriate.

If appropriate, the definition change should apply to US Core STU 3.1.0.