April 2021 SNOMED-CT Update

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On April 11, 2021, PCC updated the SNOMED-CT diagnostic terms on your practice’s PCC system to the latest code set.

PCC regularly updates your system’s ICD-10, LOINC, SNOMED-CT, NDC, RVU, VIS, and other standardized lists so you won’t encounter challenges when you chart, order a lab, interface with a care provider, or bill for a visit. (Your practice’s local system automatically updates your practice’s procedure codes.)

Read below to learn about changes to preferred terms that may affect searching, new allergies, common diagnosis descriptions that were removed from SNOMED-CT, and new additions to your practice’s quick search Favorites.

Changes to the Preferred Term for Common Descriptions

The April 2021 SNOMED-CT update changes some terms that are used at pediatric practices. Clinicians may need to type a different search word to find these descriptions than what they used before. For example, the spelling of “weal” has been changed to “wheal”, and “Adverse reaction to vaccine product” is now “Vaccine adverse reaction”.

Here is a table of common SNOMED-CT diagnosis descriptions that have new preferred terms. PCC identifies these as possibly requiring a different search term, or just being useful to know for awareness.

New Preferred Term	Old Preferred Term
Bilateral infantile esotropia of eyes	Bilateral congenital esotropia of eyes
Bullous wheal	Bullous weal
Childhood granulomatous periorificial dermatitis	Facial Afro-Caribbean childhood eruption
Chronic irritant contact dermatitis of hands	Cumulative irritant contact dermatitis of hands
Contact dermatitis caused by chlorinated hydrocarbon	Contact dermatitis due to chlorocompound
Contact dermatitis caused by feces	Feces-induced contact dermatitis
Contact dermatitis caused by fiberglass	Fiberglass dermatitis
Contact dermatitis caused by poison primrose	Contact dermatitis due to primrose
Contact dermatitis caused by ragweed	Contact dermatitis due to ragweed
Contact dermatitis caused by saliva	Saliva-induced contact dermatitis
Contact dermatitis caused by urine	Urine induced contact dermatitis
Contact dermatitis of hand	Contact hand eczema
Decreased body mass index	Body mass index below normal parameters
Dermatosis in childhood	Dermatosis in a child
Erythema multiforme due to viral disease	Erythema multiforme caused by virus
Exanthem due to varicella	Exanthem due to chicken pox
Fetal disorder due to disease in mother	Fetal damage from disease in the mother
Increased body mass index	Body mass index above normal parameters
Infantile esotropia	Congenital esotropia
Infantile esotropia of left eye	Congenital esotropia of left eye
Infantile esotropia of right eye	Congenital esotropia of right eye
Infection caused by Paragonimus westermani	Infection by Paragonimus westermanii
Irritant contact dermatitis caused by ring	Ring dermatitis
Irritant contact dermatitis due to lip-licking	Lip-licking eczema
Irritant contact dermatitis of hand	Irritant contact hand eczema
Mass of head and/or neck	Mass in head or neck
Normal body mass index	Body mass index within normal parameters
Pervasive developmental disorder with disorder of intellectual development and absence of functional language with loss of previously acquired skills	Pervasive developmental disorder with disorder of intellectual development and abscence of functional language with loss of previously acquired skills
Psoriasis of scalp	Scalp psoriasis
Psoriasis with eczema	Psoriasis-eczema overlap condition
Swelling of ear	Swelling of ear structure
Vaccine adverse reaction	Adverse reaction to vaccine product
Wheal	Weal

New Allergies of Interest to Pediatrics

The April 2021 SNOMED-CT update adds 14 allergies which may be of interest to pediatric clinicians.

Acute allergic otitis media of left middle ear

Acute allergic otitis media of right middle ear

Allergic contact dermatitis caused by grease

Allergic contact dermatitis caused by oil

Allergic contact dermatitis caused by poison primrose

Allergic contact dermatitis caused by ragweed

Allergic contact dermatitis caused by soap

Allergic contact dermatitis caused by urushiol from Eastern poison ivy

Allergic contact dermatitis caused by urushiol from poison sumac

Allergic contact dermatitis due to jewelry

Allergic reaction caused by Hevea brasiliensis latex protein

Allergy to hair dye

Bilateral acute allergic otitis media of middle ears

Bilateral chronic allergic otitis media of middle ears

Deprecated SNOMED Diagnosis Descriptions

The April 2021 SNOMED-CT update removes or replaces many codes common to pediatric practices. Your practice may want to take special note of them.

Here are the top codes used by PCC’s pediatric practices that were removed from the international SNOMED-CT diagnosis library in 2021. When practices had these codes available for one-click selection on a chart note protocol, PCC added a replacement. For other diagnoses, your providers can find related descriptions with a search, but you may want to plan ahead.

Allergy to dairy food	425525006
Allergy to latex	300916003
Blood in feces symptom	249624003
C/O – cough	272039006
C/O – low back pain	161894002
C/O – postnasal drip	162382001
C/O nasal congestion	272034001
C/O: a rash	162415008
Fetal or neonatal effect of maternal problem unrelated to pregnancy	206001006
Knee pain	30989003
O/E – erythematous rash	135888007
O/E – expiratory wheeze	162894004
O/E – general eye examination	162806009
O/E – intoeing	275864001
O/E – itchy rash	304386008
O/E – pyrexia of unknown origin	164288004
O/E – rash present	268911002
O/E – rhinorrhea	164184005
O/E – speech delay	391099000
O/E-herpes labialis-cold sore	163139004
Tick bite without infection	443930005
Unilateral earache	162358006
Unilateral undescended testis	268227001

New Favorites Available in Diagnosis Quick Search

The SNOMED-CT update adds 1710 diagnosis descriptions to your system.

In preparation for the update, PCC’s certified coder, Jan Blanchard, assembled a list of 314 new SNOMED-CT descriptions of interest to pediatricians. The update added these diagnoses, which include the COVID-19 diagnosis, to your practice’s default Favorites list for quick searching, unless your practice has specifically requested otherwise.

What is a diagnosis 'Favorites' list?: As you type or search in any diagnosis field, PCC EHR automatically searches a customizable list of Favorites. Use the Diagnosis Configuration tool to adjust your practice’s list of Favorites. You can also right-click on any diagnosis field in PCC EHR to search your system’s full SNOMED-CT diagnosis library.

Acquired cryptorchidism	Acquired cryptorchidism of left testis	Acquired cryptorchidism of right testis	Acquired structural abnormality of pharyngotympanic tube following procedure
Acute allergic otitis media of left middle ear	Acute allergic otitis media of right middle ear	Acute COVID-19	Acute mucoid otitis media of left middle ear
Adverse reaction to amoxicillin and/or clavulanic acid	Adverse reaction to ampicillin and/or floxacillin	Adverse reaction to COVID-19 antigen vaccine	Adverse reaction to COVID-19 mRNA vaccine
Adverse reaction to COVID-19 vaccine	Adverse reaction to sulfamethoxazole and/or trimethoprim	Allergic contact dermatitis caused by grease	Allergic contact dermatitis caused by oil
Allergic contact dermatitis caused by poison primrose	Allergic contact dermatitis caused by ragweed	Allergic contact dermatitis caused by soap	Allergic contact dermatitis caused by urushiol from Eastern poison ivy
Allergic contact dermatitis caused by urushiol from poison sumac	Allergic contact dermatitis due to jewelry	Allergy to hair dye	At increased risk of forced marriage
At increased risk of human trafficking	At increased risk of institutional abuse	At risk for medication error	Bilateral acute allergic otitis media of middle ears
Bilateral adhesive otitis media of middle ears	Bilateral cracked nipples	Bilateral distortion of visual image of eyes	Bilateral mucoid otitis media of middle ears
Bilateral swelling of ears	Bilateral swelling of wrist joints	Bilateral synovitis of joint of knees	Bilateral talipes calcaneovarus
Bilateral talipes equinovarus	Bilateral testicular agenesis	Blount disease	Body piercing
Breakthrough pain	Bronchial irritation	Bulimia nervosa in full remission	Bulimia nervosa in partial remission
Bursitis of left wrist	Bursitis of right wrist	Carbuncle of left axilla	Carbuncle of left lower limb
Carbuncle of left thigh	Carbuncle of right axilla	Carbuncle of right lower limb	Carbuncle of right thigh
Carrier of Staphylococcus epidermidis	Chronic papillomatous dermatitis due to contact with urine and/or feces	Chronic perichondritis of left external ear	Chronic perichondritis of right external ear
Chronic post-COVID-19 syndrome	Chronic rhinosinusitis	Chronic tubotympanic suppurative otitis media of left middle ear	Chronic tubotympanic suppurative otitis media of right middle ear
Cleft of left hard palate	Cleft of right hard palate	Complete cleft of left hard and soft palate	Complete cleft of right hard and soft palate
Conductive hearing loss of left ear	Conductive hearing loss of left ear with normal hearing on right side	Conductive hearing loss of right ear	Conductive hearing loss of right ear with normal hearing on left side
Congenital clinodactyly of finger	Congenital clinodactyly of little finger	Congenital dislocation of bilateral elbows	Congenital dislocation of joint
Congenital short ear	Congenital stenosis of male external urethral orifice	Congenital subluxation of left hip joint	Congenital subluxation of right hip joint
Congenital torsion of left ovary	Congenital torsion of right ovary	Contusion of head and/or neck	Dermatitis due to cat mite infestation
Dermatitis due to chicken mite infestation	Dermatitis due to dog mite infestation	Dermatitis due to exposure to man-made ultraviolet light	Dermatitis due to mouse mite infestation
Dermatitis due to northern fowl mite infestation	Dermatitis due to rabbit mite infestation	Dermatitis due to rat mite infestation	Developmental dysplasia of left hip
Developmental dysplasia of right hip	Distortion of visual image of left eye	Distortion of visual image of right eye	Does participate in outdoor sporting activities
Domestic abuse victim in household	Enlargement of left tonsil	Enlargement of right tonsil	Epidermal burn of left upper arm
Epidermal burn of right upper arm	Epidermal nevus of left lower eyelid	Epidermal nevus of left upper eyelid	Epidermal nevus of right lower eyelid
Epidermal nevus of right upper eyelid	Excessive intake of ascorbic acid	Excessive intake of calcium	Excessive intake of energy
Excessive intake of iron	Excessive intake of niacin	Excessive intake of phosphorus	Excessive intake of plant fiber
Excessive intake of potassium	Excessive intake of protein and protein derivative	Excessive intake of riboflavin	Excessive intake of thiamine
Excessive intake of zinc	Female genital Trichomonas vaginalis infection	Fissure of left nipple during lactation	Fissure of right nipple during lactation
Food security	Fracture of knee	Frequent attender of emergency room	Furuncle of left ankle
Furuncle of left forearm	Furuncle of left hand	Furuncle of left hip	Furuncle of right ankle
Furuncle of right forearm	Furuncle of right hand	Furuncle of right hip	Headache after cough
Hemiparesis of left side of face	Hemiparesis of right side of face	Hyperactive labyrinthine dysfunction of left inner ear	Hyperactive labyrinthine dysfunction of right inner ear
Hypersensitivity to SARS-CoV-2 mRNA vaccine	Immunization series incomplete	Inadequate intake of ascorbic acid	Inadequate intake of calcium
Inadequate intake of energy	Inadequate intake of fat and oil	Inadequate intake of iron	Inadequate intake of niacin
Inadequate intake of plant fiber	Inadequate intake of potassium	Inadequate intake of protein and protein derivative	Inadequate intake of riboflavin
Inadequate intake of thiamine	Inadequate intake of zinc	Indirect left inguinal hernia	Indirect right inguinal hernia
Infection of left nipple during lactation	Infection of right nipple during lactation	Injury of head and/or neck	Injury of muscle and tendon of lower leg
Injury of muscle of lower leg	Injury of shoulder and/or upper arm	Injury of tendon of lower leg	Injury of wrist and/or hand
Irritant contact dermatitis caused by chlorine in swimming pool	Irritant contact dermatitis caused by feces	Irritant contact dermatitis caused by grease	Irritant contact dermatitis caused by oil
Irritant contact dermatitis caused by saliva	Irritant contact dermatitis caused by urine	Irritant contact dermatitis due to concrete	Irritant contact dermatitis due to jewelry
Irritant contact dermatitis due to stoma	Irritant contact dermatitis of hand caused by grease	Irritant contact dermatitis of hand caused by oil	Irritant contact dermatitis of hand due to concrete
Itching of both hands	Lack of support for smoking cessation	Lesion of nasal cavity	Localized swelling of toe of left foot
Localized swelling of toe of right foot	Marfan syndrome type 1	Mass of left axillary region	Mass of right axillary region
Middle ear effusion	Multisystem inflammatory syndrome in children	Neonatal conjunctivitis of left eye	Neonatal conjunctivitis of right eye
Neonatal disorder due to abnormal maternal blood chemistry	Neonatal disorder due to and following amniocentesis	Neonatal disorder due to and following fetal blood sampling	Neonatal disorder due to and following operative procedure on fetus
Neonatal disorder due to and following operative procedure on mother	Neonatal disorder due to and following sampling of chorionic villus	Neonatal disorder due to chronic maternal cardiovascular disease	Neonatal disorder due to chronic maternal respiratory disease
Neonatal disorder due to disease in mother	Neonatal disorder due to maternal disorder of urinary tract	Neonatal disorder due to maternal gestational edema and proteinuria without hypertension	Neonatal disorder due to maternal hypertension
Neonatal disorder due to maternal nutritional disorder	Neonatal disorder due to maternal obesity	Neonatal disorder due to maternal obesity with adult body mass index 30 or greater but less than 40	Neonatal disorder due to maternal obesity with adult body mass index equal to or greater than 40
Neonatal disorder due to maternal overweight	Neonatal disorder due to maternal periodontal disease	Neonatal disorder due to maternal renal disease	Neonatal disorder due to maternal respiratory disease
Neonatal disorder due to maternal traumatic injury	Neonatal spontaneous cerebellar hemorrhage	Neonatal vitamin B12 deficiency due to maternal vitamin B12 deficiency	Neural hearing loss of left ear
Neural hearing loss of right ear	No cells seen in urine via microscopy	Nondependent abuse of tobacco	Nonvenomous insect bite of gum
Nonvenomous insect bite of nose	Nonvenomous insect bite of scrotum	Not entitled to social services assistance due to income above limit	Onychia of finger of left hand
Onychia of finger of right hand	Onychia of left thumb	Onychia of right thumb	Otalgia of left ear
Otalgia of right ear	Pain in left abdominal lumbar region	Pain in left lumbar region of back	Pain in right abdominal lumbar region
Pain in right lumbar region of back	Pain of joint of knee	Pain of knee region	Pain of left breast
Pain of right breast	Performs social distancing	Premature baby less than 26 weeks	Rhinoconjunctivitis
Steroid-modified tinea infection of foot	Steroid-modified tinea infection of lower limb	Strain of muscle and tendon of lower leg	Strain of muscle of lower leg
Strain of tendon of lower leg	Superficial contusion of skin of thigh	Superficial foreign body in abdominal wall	Superficial foreign body in anus
Superficial foreign body in axilla	Superficial foreign body in back	Superficial foreign body in breast	Superficial foreign body in buttock
Superficial foreign body in cheek	Superficial foreign body in chest wall	Superficial foreign body in ear	Superficial foreign body in face
Superficial foreign body in flank	Superficial foreign body in groin	Superficial foreign body in gum	Superficial foreign body in hand
Superficial foreign body in interscapular region	Superficial foreign body in lip	Superficial foreign body in neck	Superficial foreign body in nose
Superficial foreign body in penis	Superficial foreign body in perineum	Superficial foreign body in scapular region	Superficial foreign body in scrotum
Superficial foreign body in trunk	Superficial foreign body in vagina	Superficial foreign body in vulva	Superficial foreign body of abdominal wall with infection
Superficial foreign body of ankle with infection	Superficial foreign body of anus with infection	Superficial foreign body of axilla with infection	Superficial foreign body of back with infection
Superficial foreign body of breast with infection	Superficial foreign body of buttock with infection	Superficial foreign body of cheek with infection	Superficial foreign body of chest wall with infection
Superficial foreign body of ear with infection	Superficial foreign body of elbow with infection	Superficial foreign body of face with infection	Superficial foreign body of finger with infection
Superficial foreign body of flank with infection	Superficial foreign body of foot with infection	Superficial foreign body of forearm with infection	Superficial foreign body of groin with infection
Superficial foreign body of gum with infection	Superficial foreign body of hand with infection	Superficial foreign body of hip with infection	Superficial foreign body of interscapular region with infection
Superficial foreign body of lip with infection	Superficial foreign body of lower limb with infection	Superficial foreign body of neck with infection	Superficial foreign body of nose with infection
Superficial foreign body of penis with infection	Superficial foreign body of perineum with infection	Superficial foreign body of scalp with infection	Superficial foreign body of scapular region with infection
Superficial foreign body of scrotum with infection	Superficial foreign body of shoulder with infection	Superficial foreign body of testis with infection	Superficial foreign body of thigh with infection
Superficial foreign body of toe with infection	Superficial foreign body of trunk with infection	Superficial foreign body of upper arm with infection	Superficial foreign body of vagina with infection
Superficial foreign body of vulva with infection	Superficial foreign body of wrist with infection	Superficial foreign body with infection	Superficial injury of gum
Superficial injury of scapular region	Superficial injury of scrotum	Superficial injury of skin of eyelid	Sustained viral response
Tenderness of left abdominal lumbar region	Tenderness of left lumbar region of back	Tenderness of right abdominal lumbar region	Tenderness of right lumbar region of back
Undescended left testicle	Undescended right testicle	Victim of forced sexual activity	Viral load increased

SNOMED Codes Mapped to ICD-10 for Billing

The SNOMED-CT update includes new mappings to ICD-10 billing codes. Many previous mappings have been updated.

You may wish to review billing configuration for your diagnoses. You can open the Billing Configuration tool to configure which ICD-10 diagnoses are mapped to each SNOMED-CT description in PCC EHR. You can also use the snomedmap report to examine your practice’s diagnoses that may need updating.