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Type:
Change Request
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Resolution: Persuasive with Modification
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Priority:
Medium
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US Core (FHIR)
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3.2.0 [deprecated]
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Cross-Group Projects
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US Core Laboratory Result Observation Profile
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Brett Marquard/Eric Haas: 17-0-3
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Clarification
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Non-substantive
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.