# SNOMED CT code within an ordinal data element

**Category:** [Clinical](https://discourse.openehr.org/c/clinical/5)
**Created:** 2023-04-24 20:40 UTC
**Views:** 407
**Replies:** 8
**URL:** https://discourse.openehr.org/t/snomed-ct-code-within-an-ordinal-data-element/3906

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## Post #1 by @Kanthan_Theivendran

Is the annotation part of the ordinal data element a suitable place to record the SNOMEDCT code for it? Or is there another place for it?
![Screenshot 2023-04-24 at 21.34.57|690x208](upload://7itjBzZhaORiowy1kHWKqDJHF0O.png)

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## Post #2 by @siljelb

Terminology codes for data elements and value set items are connected to an archetype using bindings. Have a look in the "Terminology" tab. You have to add the terminology in the "Languages and terminologies" sub-tab before you add bindings in the "Bindings" sub-tab.

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## Post #3 by @Kanthan_Theivendran

Perfect. Thank you

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## Post #4 by @ian.mcnicoll

I completely agree with @Sijle's advice but can you share the SNOMED CT code you were trying to use?

In general SNOMED CT has (deliberately) very lean coverage of those kind of data points/ ordinal-type valuesets. And although you might find something in general examination result findings that approximates to Pain/stiffness day,  it is arguable whether that equates to data gathered as part of a very constrained score.

Not saying you are wrong!!  

Just flagging up some of the challenges we have faced historically when doing this kind of work. Even when doable it can be very time-consuming to do at scale, and one can question the value of the effort.

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## Post #5 by @Kanthan_Theivendran

Thanks Ian. Interestingly the MSK-HQ has specific codes which I have double checked on the UK NHS SNOMEDCT server from the official oxford's innovation documents:
![Screenshot 2023-04-25 at 10.56.10|685x500](upload://prm9mCX29G4CnlXObzcbf6D6wEZ.jpeg)

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## Post #6 by @ian.mcnicoll

That's interesting - I'd looked on the international SCT browser.  I would say that this level of coverage of  the individual ordinal items is pretty unusual. More commonly just the Total score is coded.

LOINC is actually much more rich in this area but strangely not MSK-HQ.

Just for further info, 'binding' the SNOMED-CT codes this way is really just 'design-time' advice. It does not mean that the SNOMED CT codes will be automatically populated into the patient record when a composition is stored. It is technically possible to do so for any coded_text or plain_text item via a structure known as `mappings` which allows multiple terms to be carried alongside the `defining_code` which in this case would be the internal atCode. However this needs to be documented for developers.

So far, we do not have an easy way of documenting this automatically in templates.

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## Post #7 by @Kanthan_Theivendran

Thanks. So from an ordinal data point of view in my creation of it it cant be reused? Does it need to be changed to coded text (instead of ordinal) to be of any value via the mappings?

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## Post #8 by @ian.mcnicoll

No sorry, I confused you  - you can actually add a binding to any node name,  and can add a binding to any coded_text, ordinal or sale values (which use coded_text internally alongside the numeric ordinal).

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## Post #9 by @Kanthan_Theivendran

This is how i've done it :
![Screenshot 2023-04-25 at 15.42.03|690x346](upload://5G7YUC9GR4lmsFkBFcn2z1butQ8.png)

Hopefully its of value and reuse.

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**Canonical:** https://discourse.openehr.org/t/snomed-ct-code-within-an-ordinal-data-element/3906
**Original content:** https://discourse.openehr.org/t/snomed-ct-code-within-an-ordinal-data-element/3906