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  1. FHIR Specification Feedback
  2. FHIR-31083

Observation.value code use LOINC in addition to SNOMED CT

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    • Change Request
    • Status: Published (View Workflow)
    • Medium
    • Resolution: Persuasive with Modification
    • US Core (FHIR)
    • 3.2.0
    • Cross-Group Projects
    • US Core Laboratory Result Observation Profile
    • Hide

      Change from

      "If a coded value, the valueCodeableConcept.code SHOULD be selected from SNOMED CT."

      to

      "If a coded value, the valueCodeableConcept.code SHOULD be selected from SNOMED CT if the concept exists."

      Show
      Change from "If a coded value, the valueCodeableConcept.code SHOULD be selected from SNOMED CT." to "If a coded value, the valueCodeableConcept.code SHOULD be selected from SNOMED CT if the concept exists ."
    • Brett Marquard/Eric Haas: 17-0-3
    • Clarification
    • Non-substantive

    Description

      The documentation for Observation.value[x] and Observation.component.value[x] states that "If a coded value, the valueCodeableConcept.code SHOULD be selected from SNOMED CT." However, there are many LOINC terms with a scale type of Ordinal or Nominal for which the Answer List contains concepts with no equivalent SNOMED CT. For example for LOINC 5782-8 (Crystals) the Answer List LL891-3 contains 25 terms. Only 16 of those have SNOMED CT codes; the other 9 only have LOINC codes. Therefore I recommend changing the documentation to "If a coded value, the valueCodeableConcept.code SHOULD be selected from SNOMED CT and/or LOINC."

      A corresponding change should also be made to the Invariants and Constraints. And add an example if possible.

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            nradov Nick Radov
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              Updated:
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