Skip Navigation Bar

Unified Medical Language System® (UMLS®)

New and Updated Sources (Expanded Representation Information) - 2014AA Release

General Information:

What's New to the Metathesaurus

For 2014AA, there is one new source, SNOMEDCT_VET, and 44 updated sources (including subsources and translation sources).

SNOMEDCT_VET, the Veterinary Extension to SNOMED CT, is a formal extension to the SNOMED CT International release, maintained by the Veterinary Terminology Services Laboratory (VTSL) at the Virginia Maryland Regional College of Veterinary Medicine. It contains content of veterinary importance as well as terms (descriptions) used by veterinarians that are not commonly used in human health.

For detailed information about sources that are new or have had changes made (e.g. new term types, new attribute names, etc.):

Code on Dental Procedures and Nomenclature, CDT2014
Current Procedural Terminology, CPT2014
Healthcare Common Procedure Coding System, HCPCS2014
International Classification of Diseases, 10th Edition, Clinical Modification, ICD10CM_2014
ICD-10-PCS, ICD10PCS_2014
Logical Observation Identifiers Names and Codes (LOINC), LNC246
Descritores em Ciencias da Saude (Portuguese translation of the Medical Subject Headings), MSHPOR2014
RXNORM Vocabulary, RXNORM_13AB_140303F
SNOMED Clinical Terms, Spanish Language Edition, SCTSPA_2013_10_31
SNOMED CT US Edition, SNOMEDCT_US_2014_03_01
Veterinary Extension to SNOMED CT, SNOMEDCT_VET_2013_10_25


------------------------------------------

What's New to the Metathesaurus:

Attribute name (ATN):
      ADDITIONAL_GUIDELINE
      ADDON_CODE
      CPT_LEVEL
      DESCRIPTOR_EXTENSION
      EXEMPT_MOD
      FDA_APPROVAL_PENDING
      MEASURE_DEVELOPER
      MODERATE_CONSCIOUS_SEDATION

Relationship attribute (RELA)| RELA inverse:
      has_panel_element | panel_element_of
      has_life_circumstance | life_circumstance_of
      has_physiologic_state | physiologic_state_of
      includes_sub_specimen | sub_specimen_included_by

------------------------------------------
Source: Code on Dental Procedures and Nomenclature
VSAB: CDT2014

1. New term type (TTY) | Suppressible value:
      OP|O


Discussion:

ATN = CHANGE_CLASS identifies the type of change made to this version of the code. New value: 99 (code no longer valid). All codes assigned this value also assigned the TTY=OP.

------------------------------------------
Source: Current Procedural Terminology
VSAB: CPT2014

1. Deprecated subsource: MTHCH2014

2. New term type (TTY) | Suppressible value:
      HT|N

3. Dropped term type (TTY) | Source:
      HT|MTHCH

4. New relationship | relationship attribute (RELA) | RELA inverse:
      RO|has_panel_element|panel_element_of

5. Dropped relationship | relationship attribute (RELA):
      RN|(blank)
      RO|(blank)

6. New attribute name (ATN):
      ADDITIONAL_GUIDELINE
      ADDON_CODE
      CPT_LEVEL
      DATE_CREATED
      DATE_LAST_MODIFIED
      DESCRIPTOR_EXTENSION
      EXEMPT_MOD
      FDA_APPROVAL_PENDING
      MEASURE_DEVELOPER
      MODERATE_CONSCIOUS_SEDATION

7. Dropped attribute name (ATN):
      CPT_CLINICIAN_DESC_ID


Discussion:

1. For this year, the Developers Toolkit Version of CPT (DTK) was used which includes a hierarchy.

2. MTH version of the source (SAB=MTHCH) was been deprecated.

3. New RELA = has_panel_element/panel_element_of indicates that a CPT laboratory panel test is a member of a laboratory panel.

4. New ATN = ADDITIONAL_GUIDELINE provides additional explanatory text that is applicable to a concept (code/heading/subheading).

5. New ATN = ADDON_CODE. A value of 'T' in this field indicates that it is an 'Add-on code (i.e. it is commonly carried out in addition to the primary procedure performed).

6. New ATN = CPT_LEVEL represents the level of a code. Values range from H1 (a top-level heading such as 'Surgery') to H6 (a 6th-level subheading) and HS (a heading for a small family of related codes), PC (for Parent Code), or CC (for Child Code).

7. New ATN = DESCRIPTOR_EXTENSION. The extension of the full description of the concept (e.g., the CPT code's long descriptor, as listed in the CPT book).

8. New ATN = EXEMPT_MOD. Valid values = 51 or 63.

9. New ATN = APPROVAL_PENDING. Valid value = T for codes marked with the FDA approval pending symbol.

10. New ATN = MEASURE_DEVELOPER contains the name of the measure developer associated with the Category II code.

11. New ATN = MODERATE_CONSCIOUS_SEDATION. Valid value = T for codes marked by the moderate (conscious) sedation symbol.

------------------------------------------
Source: Healthcare Common Procedure Coding System
VSAB: HCPCS2014

This version includes:
      HCDT2014
      HCPT2014
      MTHHH2014

1. Dropped term type (TTY) | Source(s):
      MTH_PT|HCPCS, HCPT

2. Dropped relationship | relationship attribute (RELA) | Source(s):
      SY|mth_plain_text_form_of|HCPCS, HCPT


Discussion:

Metathesaurus created atoms and relationships (e.g., MTH_PT, mth_plain_text_form_of) that were created as a result of needing plain text versions of UTF-8 strings have been deprecated.

------------------------------------------
Source: International Classification of Diseases, 10th Edition, Clinical Modification
VSAB: ICD10CM_2014

1. Dropped term type (TTY):
      MTH_AB
      MTH_ET
      MTH_HT
      MTH_PT

2. Dropped relationship | relationship attribute (RELA):
      SY|mth_has_plain_text_form

3. Dropped attribute name (ATN):
      MTH_CODE_FIRST
      MTH_EXCLUDES1
      MTH_EXCLUDES2


Discussion:

1. ICD-10-CM is the replacement to ICD-9-CM.

2. Metathesaurus created atoms, attributes, and relationships (e.g., MTH_ET, mth_has_plain_text_form, MTH_EXCLUDES1, etc.) that were created as a result of needing plain text versions of UTF-8 strings have been deprecated.

------------------------------------------
Source: ICD-10-PCS
VSAB: ICD10PCS_2014

1. New term type (TTY) | Suppressible value:
      XM|N

2. New attribute name (ATN):
      FROMRSAB
      FROMVSAB
      MAPSETRSAB
      MAPSETVERSION
      MAPSETVSAB
      MAPSETXRTARGETID
      MTH_MAPFROMCOMPLEXITY
      MTH_MAPFROMEXHAUSTIVE
      MTH_MAPSETCOMPLEXITY
      MTH_MAPTOCOMPLEXITY
      MTH_MAPTOEXHAUSTIVE
      SOS
      TORSAB
      TOVSAB
      XMAP
      XMAPFROM
      XMAPTO


Discussion:

1. New mapping information provided.

2. The hierarchical term "Radiation Oncology" has been changed to "Radiation Therapy".

------------------------------------------
Source: Logical Observation Identifiers Names and Codes (LOINC)
VSAB: LNC246

1. Deprecated subsources:
      LNC246_ASQ_3_2009
      LNC246_BRADEN_1988
      LNC246_CAM_2003
      LNC246_FACIT
      LNC246_FLACC_1997
      LNC246_MDS20
      LNC246_MLHFQ_1986
      LNC246_NEUROQOL_2010
      LNC246_NPUAP_2012
      LNC246_OASIS_2002
      LNC246_OPTIMAL_2005
      LNC246_PHQ_9_1999
      LNC246_RHO_2008
      LNC246_SPERTUS_2005
      LNC246_VR_12_2004
      LNC246_WHO_2006

2. New relationship | relationship attribute (RELA) | RELA inverse:
      RN|member_of|has_member


Discussion:

1. Subsources are no longer being created. The content from these subsources is included in the Metathesaurus under the single SAB = LNC.

2. The hierarchy has been changed from SAUI-based to SCUI-based.

3. New RELA = member_of represents the relationships between lab panels and their members.

-----------------------------------------------
Source: Descritores em Ciencias da Saude (Portuguese translation of the Medical Subject Headings)
VSAB: MSHPOR2014

1. Dropped term type (TTY):
      HT
      PEN
      PXQ
      SY
      TQ
      XQ

2. Dropped relationship | relationship attribute (RELA):
      SY|translation_of

3. New attribute name (ATN):
      TERMUI


Discussion:

This version of MSHPOR was received from the MeSH Translation Maintenance System (MTMS). The top level of the hierarchy no longer exists and there are no qualifiers.

----------------------------------------------
Source: RXNORM Vocabulary
VSAB: RXNORM_13AB_140303F

This version includes:
      ATC_2014_14_03_03 (Anatomical Therapeutic Chemical Classification System)
      GS_2014_02_06 (Gold Standard Drug Database)
      MDDB_2014_01_29 (Master Drug Data Base. Medi-Span, a division of Wolters Kluwer Health)
      MMSL_2014_02_03 (Multum MediSource Lexicon)
      MMX_2014_02_03 (Micromedex RED BOOK)
      MTHFDA_2011_06_01_13_05_06 (FDA National Drug Code Directory)
      MTHSPL_2014_02_24 (FDA Structured Product Labels)
      NDDF_2014_02_05 (FDB MedKnowledge)
      NDFRT_2014_02_03 (National Drug File)
      VANDF_2014_01_23 (Veterans Health Administration National Drug File)

1. Dropped term type (TTY) | Source(s):
      FN|NDFRT_2014_02_03
      HT|NDFRT_2014_02_03

2. New relationship | relationship attribute (RELA) | RELA inverse | Source(s):
      RO|has_member|member_of|ATC_2014_14_03_03

3. Dropped relationship | relationship attribute (RELA) | Source(s):
      RO|active_metabolites_of|has_active_metabolites|NDFRT_2014_02_03
      RO|chemical_structure_of|has_chemical_structure|NDFRT_2014_02_03
      RO|contraindicated_with_disease|disease_with_contraindication|NDFRT_2014_02_03
      RO|contraindicating_class_of|has_contraindicating_class|NDFRT_2014_02_03
      RO|contraindicating_mechanism_of_action_of|has_contraindicating_mechanism_of_action|NDFRT_2014_02_03
      RO|contraindicating_physiologic_effect_of|has_contraindicating_physiologic_effect|NDFRT_2014_02_03
      RO|effect_may_be_inhibited_by|may_inhibit_effect_of|NDFRT_2014_02_03
      RO|has_contraindicated_drug|drug_contraindicated_for|NDFRT_2014_02_03
      RO|has_mechanism_of_action|mechanism_of_action_of|NDFRT_2014_02_03
      RO|has_participant|participates_in|NDFRT_2014_02_03
      RO|has_pharmacokinetics|pharmacokinetics_of|NDFRT_2014_02_03
      RO|has_physiologic_effect|physiologic_effect_of|NDFRT_2014_02_03
      RO|has_product_component|product_component_of|NDFRT_2014_02_03
      RO|has_therapeutic_class|therapeutic_class_of|NDFRT_2014_02_03
      RO|induced_by|induces|NDFRT_2014_02_03
      RO|may_be_diagnosed_by|may_diagnose|NDFRT_2014_02_03
      RO|may_be_prevented_by|may_prevent|NDFRT_2014_02_03
      RO|may_be_treated_by|may_treat|NDFRT_2014_02_03
      RO|metabolic_site_of|site_of_metabolism|NDFRT_2014_02_03

4. Dropped attribute name (ATN) | Source(s):
      FDA_UNII_CODE|NDFRT_2014_02_03
      LEVEL|NDFRT_2014_02_03
      MESH_DEFINITION|NDFRT_2014_02_03
      MESH_DUI|NDFRT_2014_02_03
      MESH_NAME|NDFRT_2014_02_03
      MESH_UI|NDFRT_2014_02_03
      NDFRT_KIND|NDFRT_2014_02_03
      NDF_UNITS|NDFRT_2014_02_03
      NUI|NDFRT_2014_02_03
      SEVERITY|NDFRT_2014_02_03
      SNOMED_CID|NDFRT_2014_02_03
      STRENGTH|NDFRT_2014_02_03
      VANDF_RECORD|NDFRT_2014_02_03
      VA_IEN|NDFRT_2014_02_03
      VUID|NDFRT_2014_02_03


Discussion:

1. MTHFDA is included in each Metathesaurus release as part of RxNorm, however, it was not updated in this version. MTHFDA was last updated in 2011.

2. Selected portions of MSH and SNOMEDCT_US are included in the RxNorm release files, however, they are not processed as part of RxNorm for the Metathesaurus except in assigning RXCUI and RXAUI attributes.

------------------------------------------------------------
Source: SNOMED Clinical Terms, Spanish Language Edition
VSAB: SCTSPA_2013_10_31

1. New term type (TTY)| Suppressible value:
      MTH_OAF|O
      MTH_OAP|O
      MTH_OAS|O
      OAF|O
      OAP|O
      OAS|O


Discussion:

1. TTY=OAF represents the obsolete active fully specified term.

2. TTY=OAP represents the obsolete active preferred term.

3. TTY=OAS represents the obsolete active synonym.

4. TTY=MTH_* represents the Metathesaurus-supplied form of the term.

------------------------------------------------------------
Source: SNOMED CT US Edition
VSAB: SNOMEDCT_US_2014_03_01

1. New term type (TTY) | Suppressible value:
      MTH_OP|O

2. New relationship | relationship attribute (RELA) | RELA inverse:
      RO|translation_of|has_translation

---------------------------------------------------------------
Source: Veterinary Extension to SNOMED CT
VSAB: SNOMEDCT_VET_2013_10_25

1. New term type (TTY) | Suppressible value:
      FN|N
      IS|O
      OAF|O
      OAP|O
      OAS|O
      OF|O
      OP|O
      PT|N
      SB|N
      SY|N

2. New relationship | relationship attribute (RELA) | RELA inverse:
      CHD|isa|inverse_isa
      RO|(blank)|(blank)
      RO|associated_with|associated_with
      RO|due_to|cause_of
      RO|has_associated_morphology|associated_morphology_of
      RO|has_causative_agent|causative_agent_of
      RO|has_clinical_course|clinical_course_of
      RO|has_component|component_of
      RO|has_definitional_manifestation|definitional_manifestation_of
      RO|has_direct_device|direct_device_of
      RO|has_direct_procedure_site|direct_procedure_site_of
      RO|has_direct_substance|direct_substance_of
      RO|has_finding_method|finding_method_of
      RO|has_finding_site|finding_site_of
      RO|has_focus|focus_of
      RO|has_indirect_procedure_site|indirect_procedure_site_of
      RO|has_intent|intent_of
      RO|has_interpretation|interpretation_of
      RO|has_laterality|laterality_of
      RO|has_life_circumstance|life_circumstance_of
      RO|has_method|method_of
      RO|has_pathological_process|pathological_process_of
      RO|has_physiologic_state|physiologic_state_of
      RO|has_procedure_site|procedure_site_of
      RO|has_specimen|specimen_of
      RO|has_specimen_procedure|specimen_procedure_of
      RO|has_specimen_source_identity|specimen_source_identity_of
      RO|has_specimen_source_morphology|specimen_source_morphology_of
      RO|has_specimen_source_topography|specimen_source_topography_of
      RO|has_specimen_substance|specimen_substance_of
      RO|has_subject_relationship_context|subject_relationship_context_of
      RO|includes_sub_specimen|sub_specimen_included_by
      RO|interprets|is_interpreted_by
      RO|occurs_after|occurs_before
      RO|occurs_in|has_occurrence
      RO|possibly_equivalent_to|possibly_equivalent_to
      RO|replaced_by|replaces
      RO|uses_device|device_used_by
      RO|uses_substance|substance_used_by
      SY|same_as|same_as

3. New attribute name (ATN):
      ACTIVE
      CASE_SIGNIFICANCE_ID
      CHARACTERISTIC_TYPE_ID
      DEFINITION_STATUS_ID
      INACTIVATION_INDICATOR
      LANGUAGECODE
      MODIFIER_ID
      SUBSET_MEMBER
      TYPE_ID
      UMLSREL
      UMLSRELA


Discussion:

1. This is a new source.

2. TTY=SB (Subset) represent atoms for each refset that has SUBSET_MEMBER attributes. The term names and SCUIs for these SB atoms come from the SNOMEDCT_US source, which SNOMEDCT_VET refers to.

3. TTY=OAF represents the obsolete active fully specified term.

4. TTY=OAP represents the obsolete active preferred term.

5. TTY=OAS represents the obsolete active synonym.

6. ATN=ACTIVE - valid values: 1 for active, 0 for inactive.

7. ATN=CASE_SIGNIFICANCE_ID - concept id indicating case significance.

8. ATN=CHARACTERISTIC_TYPE_ID - concept id indicating relationship characteristic type.

9. ATN=DEFINITION_STATUS_ID - concept id indicating definition status (e.g., primitive).

10. ATN=INACTIVATION_INDICATOR - concept id indicating reason for inactivation.

11. ATN=MODIFIER_ID - concept id indicating relationship modifier (existential).

12. ATN=SUBSET_MEMBER - subset member, used for ref set members.

13. ATN=TYPE_ID - concept id indicating relationship type.

14. ATN=UMLSREL - UMLS REL value used for a SNOMEDCT_VET relationship.

15. ATN=UMLSRELA - UMLS RELA value used for a SNOMEDCT_VET relationship.