About the New Zealand Edition

Te Whatu Ora - Health New Zealand works with health and disability agencies and their industry partners to publish a standard set of SNOMED CT content for digital health solutions in Aotearoa New Zealand. The SNOMED CT New Zealand Edition is our standard product.

The SNOMED CT New Zealand Edition is released every April and October and comprises the latest designated SNOMED CT International Edition release and the SNOMED CT NZ Extension.

The content can be downloaded from our member licensing and distribution service or accessed via FHIR® API using the NZ Health Terminology Service (NZHTS)

We welcome your feedback and participation. For more information about SNOMED CT implementation in New Zealand, see our website or join our standards channel at ehealthforum.nz

The SNOMED CT NZ Edition is a comprehensive source of concepts and terms for recording health information at point of care. All local content is governed by recognised national clinical networks.

You can browse all New Zealand and international content using the SNOMED CT browser. Look for our national flag and click 'Go browsing New Zealand Edition'.

 

October 2023 release

The October 2023 release of the SNOMED CT NZ Edition is the current release. It comprises the July 2023 release of the SNOMED CT International Edition and the October 2023 release of the SNOMED CT NZ Extension.

The October 2023 release updates the previous release in April 2023 with many new concepts and terms that fulfil content requests and support new standards.

See the October 2023 release note for details.

Reference sets

SNOMED CT reference sets are created whenever it is useful to narrow the selection of concepts for some purpose. For many purposes, reference sets are not required and SNOMED CT expression constraint language can be used to guide the user and enforce business rules.

 

The latest release includes the following reference sets and the content of each can be viewed online in the SNOMED International reference set directory at SNOMED Reference Set and Translation Service.  We provide the SNOMED CT identifier (SCTID) for each reference set because calls to the application programming interface (API) need to include SCTID.

 

Another way to access the reference sets is to use NZHTS and its FHIR API. Software applications can be integrated with the terminology service for real-time access to the reference sets.

Adverse reaction manifestation reference set

The adverse reaction manifestation reference set represents the most commonly encountered manifestations of allergic reactions and other adverse reactions at a level of detail for adverse reaction reporting and personal health records. The refset is maintained by the HISO adverse reaction reporting standard working group.

The adverse event from immunisation reference set is a subset of the above that is used to record reactions to vaccines, such as in the COVID-19 immunisation register.

  • 351000210106 New Zealand adverse reaction manifestation reference set
  • 61231000210108 New Zealand COVID-19 adverse reaction event from immunisation reference set

Alcohol consumption reference set

The alcohol consumption reference set is used to record the status of alcohol consumption. 

  • 72671000210109 New Zealand alcohol consumption reference set

Ambulance clinical impression reference set

The ambulance clinical impression reference set includes the concepts paramedics use to represent clinical impressions in the national ePRF system.

This reference set is maintained by the ambulance sector.

  • 421000210109 New Zealand ambulance clinical impression reference set

Assistance and preferences reference set

The assistance and preferences reference set identifies the types of assistance requirements, preferences or dependencies that may be recorded about a person and their needs.

  • 303431000210106 New Zealand assistance and preferences reference set

CanShare reference sets

Te Aho o Te Kahu (Cancer Control Agency) has produced a collection of 298 CanShare reference sets for Aotearoa. These reference sets provide standard sets of SNOMED CT concepts to use for recording, sharing and querying cancer data in Aotearoa. They are designed to support a range of cancer data, including histology, topography, grading, staging, scoring, treatment intents, disease response, and cancer streams. 

The October 2023 NZ SNOMED CT edition includes 226 new CanShare reference sets and 15 updated reference sets in the following areas:

  • Cancer histologies for haematolymphoid, breast, thoracic, female genital, digestive and genitourinary tumours, based on the WHO Classification of Tumours 5th edition.
  • Topographies for recording the body location of a cancer. This includes a maximal set of body locations, a high-level set of commonly used body locations, and body locations for specific thoracic and breast cancers.
  • Grading systems and their values for haematolymphoid and breast cancers.
  • Staging systems and their values for haematolymphoid, breast and thoracic cancers
  • Prognostic scoring systems and their values for haematolymphoid cancers.
  • Cancer groupings to support clinical workflows.
  • Data that supports systemic anti-cancer therapy treatment plans, including basis of diagnosis, treatment intent, disease response, dose forms, dose units, and ancillary studies for breast tumours.

Common allergen reference sets

These reference sets are needed in patient record systems to indicate the substance suspected to have caused an adverse reaction.

  • 61241000210100 New Zealand biological substance common allergen reference set
  • 61251000210102 New Zealand chemical substance common allergen reference set
  • 61261000210104 New Zealand edible substance common allergen reference set

HealthShare has led the development of these reference sets, in collaboration with DHBs, for the Midland clinical portal project.

Common patient friendly terms reference set

This reference set covers the most common health conditions and interventions, each with equivalent New Zealand English and te reo Māori consumer and whānau friendly terms.

  • 263811000210108 New Zealand common patient friendly terms reference set

Disability reference set

The disability reference set identifies the types of disability that may be recorded about a person and their needs.

  • 261000210101 New Zealand disability reference set

Emergency care reference sets

Three reference sets provide emergency department clinicians with a standard set of concepts for chief presenting complaint and diagnosis.

Hospitals submit SNOMED-coded ED visit data to the National Non-Admitted Patient Collection (NNPAC). NCAMP 2020 introduced this requirement for all hospitals from 1 July 2021.

A national ED clinical information reference group meets every six months to oversee the content of these refsets and their use.

  • 61000210102 New Zealand emergency care diagnosis reference set
  • 71000210108 New Zealand emergency care presenting complaint reference set
  • 321000210102 New Zealand emergency care procedure reference set

Family planning reference set

The New Zealand Family Planning reference set identifies common symptoms, diagnoses and procedures that are referred to when seeing patients for their sexual and reproductive health. This content has been developed in partnership with New Zealand Family Planning.

  • 263311000210103 New Zealand family planning reference set

Female pelvic surgical mesh injury reference set

This reference set has been developed to provide clinicians with a standard set of diagnosis codes to capture injuries and complications due to the implantation of surgical mesh to treat female stress urinary incontinence and pelvic organ prolapse.

The set is developed and maintained by the New Zealand Female Pelvic Mesh Service.

  • 299111000210100 New Zealand female pelvic surgical mesh injury reference set (foundation metadata concept)

Gateway child health assessment reference set

This reference set includes needs and recommendations concepts used in Gateway child assessments. There are plans to extend the reference set to other parts of the assessment.

The Ministry of Health is working with Oranga Tamariki to develop this content.

  • 241000210102 New Zealand child health assessment reference set

Health consumer information reference set

The New Zealand health consumer information reference set consists of common terms used on websites and in patient information leaflets to describe diseases, tests and treatments (other than medicines) in a form consumer and whānau can understand. This content has been developed in partnership with Healtify | He Puna Waiora.

  • 263301000210100 New Zealand health consumer information reference set

Health service type, occupation, clinical specialty and site of care reference sets

The health service type, occupation, clinical specialty and site of care reference sets have been created for consistency in recording health workforce and service delivery information, including clinical document metadata.

These reference sets enumerate health service types (eg clinical pharmacology service, endoscopy service), professional occupations (eg obstetrician, clinical pharmacist, dietitian, audiologist), clinical specialties (eg obstetrics and gynaecology, dietetics and nutrition, general practice) and sites of care (eg general practice premises, nursing home, hospital department).

  • 471000210108 New Zealand clinical specialty reference set
  • 451000210100 New Zealand health occupation reference set
  • 461000210102 New Zealand health service type reference set
  • 481000210105 New Zealand site of care reference set

Maternity reference sets

The following reference sets provide the ability to capture relevant maternity details for a pregnant woman.

  • 72621000210105 New Zealand maternity Apgar score reference set
  • 72631000210107 New Zealand maternity complimentary therapies reference set
  • 72601000210102 New Zealand maternity complications reference set
  • 72611000210100 New Zealand maternity disorders reference set
  • 72661000210103 New Zealand maternity family history reference set
  • 72591000210107 New Zealand maternity findings reference set.
  • 72581000210105 New Zealand maternity mode of delivery reference set
  • 72571000210108 New Zealand maternity outcomes reference set
  • 72561000210102 New Zealand maternity procedures reference set
  • 72641000210104 New Zealand maternity screening and tests reference set
  • 72651000210101 New Zealand maternity substances reference set
  • 72541000210103 New Zealand maternity previous complications reference set
  • 72551000210100 New Zealand maternity previous disorders reference set
  • 72531000210106 New Zealand maternity previous findings reference set.
  • 72521000210109 New Zealand maternity previous mode of delivery reference set
  • 72511000210104 New Zealand maternity previous outcomes reference set
  • 72501000210101 New Zealand maternity previous procedures reference set

Laboratory order reference set

To support laboratory test ordering, the pathology test request reference set developed by the Royal College of Pathologists of Australasia (RCPA) is included in this release.

  • 501000210102 New Zealand laboratory order reference set

Microorganism reference set

The microorganism reference set is the agreed standard for microbiology and infection control and includes all microorganisms in the SNOMED CT International Edition.

HISO, the NZ Microbiology Network and the National Pathology and Laboratory Round Table are co-stewards of the reference set and its adoption.

  • 391000210104 New Zealand microorganism reference set

Minor procedures reference sets

A collection of five reference sets has standard codes for recording minor procedures performed in outpatient clinics. Reporting the procedure performed for the five purchase units listed below will reduce the number of new purchase units required for specific procedures and will allow more accurate counting of some procedures – for example, when NNPAC data is linked to hospital costing data.

  • New Zealand purchase unit code S00008 minor operation reference set
  • New Zealand purchase unit code S25006 ear, nose, and throat minor operation reference set
  • New Zealand purchase unit code S30008 gynaecology minor procedure reference set
  • New Zealand purchase unit code S40008 eye procedure reference set
  • New Zealand purchase unit code S60007 plastic surgery minor procedure reference set

National Patient Flow reference sets

The nine reference sets released so far include the most common presenting reason and diagnosis concepts used in cardiology, gynaecology, rheumatology, endocrinology, general surgery, ophthalmology, nephrology, general paediatric and child development outpatient services.

The reference sets are defined at a suitable level of detail for outpatient services and may be extended in future for other purposes. These reference sets use the standard terms of the SNOMED CT International Edition for the moment. New Zealand preferences for new or different terms per concept will be introduced in a later release.

We work with recognised sector groups to develop and maintain these reference sets.

  • 91000210107 New Zealand cardiology reference set
  • 191000210102 New Zealand child developmental services reference set
  • 141000210106 New Zealand endocrinology reference set
  • 181000210104 New Zealand general paediatric reference set
  • 131000210103 New Zealand general surgery reference set
  • 101000210108 New Zealand gynaecology reference set
  • 50931000210104 New Zealand nephrology reference set
  • 50941000210107 New Zealand ophtalmology reference set
  • 121000210100 New Zealand rheumatology reference set
  • 192091000210104 New Zealand suspicion of cancer reference set

Non-medicinal drug reference set

This reference set is used to record the most encountered drugs not legally prescribed.

  • 72691000210108 New Zealand non-medicinal drug reference set

Notifiable disease reference set

The notifiable disease reference set identifies all notifiable diseases in New Zealand. The reference set may be extended for reporting disease subtypes.

We work with ESR to manage this reference set.

  • 251000210104 New Zealand notifiable disease reference set

Oral health reference set

This reference set identifies terms to be captured in an oral health information system to support community oral health services, Māori oral health services and hospital dental services.

  • 301951000210106 New Zealand oral health reference set

Pharmaceutical dose reference sets

New Zealand common pharmaceutical dose form reference set. Needed in prescribing and patient record systems to record the dose form (eg, capsule) of a medicine or vaccine.

New Zealand common pharmaceutical dose frequency reference set. Needed in prescribing and patient record systems to record the dose frequency (eg, once a day) of a medicine or vaccine.

New Zealand common pharmaceutical dose unit reference set. Needed in prescribing and patient record systems to record the dose unit (eg, mg) in the strength or dose quantity of a medicine or vaccine.

  • 61271000210105 New Zealand common pharmaceutical dose form reference set
  • 61281000210107 New Zealand common pharmaceutical dose frequency reference set.
  • 61291000210109 New Zealand common pharmaceutical dose unit reference set

Radiology procedure reference set

The radiology procedures reference set has been developed by the Te Manawa Taki project to deliver a radiology e-ordering solution for hospitas in the central North Island. The refset provides a standard coded term for recording each radiology procedure. The refset can be used and extended by other implementers of radiology ordering systems around the country.

  • 121531000210107 New Zealand radiology procedures reference set

Rheumatic fever reference set

The goal of this reference set is to harmonise capture of information relating to the diagnosis and management of rheumatic fever related conditions, including acute rheumatic fever and rheumatic heart disease, in New Zealand.  

The reference set is for use by all practitioners involved in the care of patients with rheumatic fever. 

Using this reference set will enable standardised care plans and case management records, enabling nationally-consistent management of cases, reducing the risk of severe rheumatic heart disease, and improving health outcomes.

  • 303391000210104 New Zealand rheumatic fever reference set

Referral reference set

The referral reference sets include concepts that can be used at point of care to capture details of a referral.

This reference set identifies the status of referral request in the receiving organisation.

  • 192071000210103 New Zealand referral status reference set.

The following reference set identifies the clinical priority score that is assigned by a clinician to indicate the relative urgency of a referral.

  • 192081000210101 New Zealand priority score reference set

Severe acute respiratory syndrome coronavirus 2 symptoms reference set

COVID-19 symptoms reference set has been created to capture COVID symptoms identified by the Ministry of Health. This can be used for capturing symptoms when someone is undergoing a COVID-19 related assessment or test.

  • 121521000210105 New Zealand severe acute respiratory syndrome coronavirus 2 symptoms reference set 

Smoking and vaping reference set

The smoking reference set is the standard set of coded terms for recording smoking status for anyone smoking, trying to quit smoking or ex-smoking.

The vaping status reference set is the standard set of coded terms for recording vaping status for anyone vaping, trying to give up vaping or ex-vaping.

The New Zealand smoking intervention reference set is the standard set of coded terms for recording smoking cessation support offered to individuals.

These reference sets support Smokefree Aotearoa 2021 

The Ministry of Health maintains this reference set.

  • 72741000210106 New Zealand smoking status reference set
  • 72721000210100 New Zealand vaping status reference set
  • 72731000210103 New Zealand smoking intervention reference set

Surgical complications reference set

The surgical complications reference set includes clinical findings and disorders related to general surgery.

Thanks to Canterbury DHB and their industry partners for the content and their commitment to this work.

A clinical governance group meets regularly to further develop this refset and others for surgical information.

  • 441000210103 New Zealand surgical complication reference set

Maps

The release includes the following maps between SNOMED CT and other terminologies and code systems.

READ v2 to SNOMED CT map

This unidirectional map from READ v2 to SNOMED CT is provided to aid migration to SNOMED CT in primary care.

We acknowledge NHS Digital for the source data for this map, made available to us under an Open Government Licence. Our version of the map was updated most recently from the NHS Digital data migration release dated October 2018. 

NZMT medicinal product to SNOMED CT map

This map associates NZ Medicines Terminology medicinal product concepts to SNOMED CT concepts. There one-to-one mappings from NZMT concepts to equivalent SNOMED CT concepts where they exist, and many-to-one mappings from NZMT concepts to somewhat less specific SNOMED CT concepts otherwise.

This map is an RF2 version of the equivalent map maintained and documented in NZ Universal List of Medicines releases.

The version of the map included here comes from the NZULM February 2020 release.

ACC SNOMED CT to READ v2 translation table

This unidirectional map from SNOMED CT to READ v2 is used and maintained by ACC to help process SNOMED-coded personal injury claims. The table includes some content from the NHS Digital primary care refset equivalence tables.

Language reference sets

Language reference sets are created to define the preferred terms and synonyms associated with each concept in some context. This release includes the following language reference sets.

NZ English language reference set

This language reference set has preferred terms, synonyms and correct spellings for all concepts in the SNOMED CT NZ Edition. It is derived from the GB English language refset included with the SNOMED International Edition, and covers the terms included in the SNOMED NZ Extension.

NZ English patient and consumer friendly terms language reference set

This language reference set has patient and consumer friendly terms in NZ English covering the most common health conditions and interventions. The reference set is intended for use in consumer-facing applications, including patient portals and personal health apps.

THINK Hauora has led the development of this content, working with the Ministry of Health.

Te Reo Māori patient and consumer friendly terms language reference set

This language reference set has patient and consumer friendly terms in te reo Māori covering the most common health conditions and interventions. The reference set is intended for use in consumer-facing applications, including patient portals and personal health apps. The first version in October 2020 is offered for trial use and comment.

We acknowledge Te Tihi o Ruahine and THINK Hauora, who have led the development of this content.

CanShare context language reference set

This language reference set has preferred terms, synonyms and correct spellings for all concepts that will be used in collecting, reporting and sharing cancer information. The reference set is intended for use in recording cancer data in New Zealand.

Future development

The following reference sets are among those planned for future development:

  • Cancer
  • Cardiothoracic surgery
  • Dermatology
  • ENT
  • Gastroenterology
  • General medicine (excluding endocrine and diabetes)
  • Neurology
  • Neurosurgery
  • Oncology
  • Orthopaedic surgery
  • Plastics
  • Respiratory
  • Urology