This page provides details about terminologies used in HL7 standards but owned and governed by other organisations external to HL7.  The HL7 Terminology Authority supports the HL7 community by providing this information about external code systems for use in HL7 specifications.

Intellectual Property and Copyright

Implementers and testers using/referencing any of these code systems for any terminology content artefact in an HL7 specification SHALL abide by the specific license requirements for the relevant terminology.  Terminology licenses SHALL be obtained from the code system owner for each code system and/or other specified artefact used. It is the sole responsibility of each organization deploying or testing any HL7 specification to ensure their implementations complies with licensing requirements of each external terminology used.

Please note that some external, licensed code systems present in HL7 specifications are subject to third-party copyrights (e.g., proprietary assessment scale content in LOINC, and/or translated text). Your use of these works must comply with applicable third-party terms of use.  For further information and for details of how implementers should manage the license and use of third-party content, please see the copyright information provided by the relevant code system authority.

An index of all code system records may be found on here: HTA — External Terminologies - Information – Code System Metadata Records Index

Information provided about external terminologies includes: 

  • Owner of the terminology
  • Arrangement or agreements with HL7 for use of content
  • Formal name of the code system
  • Short name or abbreviation of the code system name
  • Technical identifier/s of the code  system (OIDs, URI etc)
  • Link to information about the code system - including how to obtain the content
  • Version management: timing and identification of versions
  • IP Information and Licensing 
  • HL7 users of this information - which HL7 products use this link (if known)
  • Information current as at (date)
  • Scope/domain statement

External Terminology Information

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  1. Do we include national terminologies e.g. ICD-10-GM?

    1. Yes these are all external terminologies - however HTA only deal with international code systems - but we also advise affiliates where relevant.

      1. Is there a reason why you deleted international terminologies e.g. ICD-10-GM? Do we harmonize our work with

        1. I agree with Sylvia. I don't understand why 1CD-10-GM was removed

        2. I suspect that the ICD section is being "tidied"....but I don't know why we'd delete the ICD-10-GM....I think it is an external code system in its own right.....

          I know that we have to work out how to deal with "national extensions" - for SNOMED CT and for these others that follow this sort of "extension pattern".....I'll put it on the agenda for our meeting next week.

          1. Hi All - 

            Apologies, this was an unintended consequence of changing the source of this content to make it easier to maintain. Previously, it was a manually maintained list. After creating a new page, we had to separately create an entry here, organize it within the hierarchy the same way it appears in the tree navigation etc.. Instead, the page now utilizes the "Children Of" Confluence module. Thus, anything that previous appeared but does not have a corresponding page (includes the items below that appear in black/i.e., have no URL link to a page), are no longer included in the list.

            Julie, do you feel that we need to add them back? I can include them in the "Grouper page" (see ICD Family of Classifications (World Health Organisation) as a an example).

  2. How do I get the ball rolling on the vocabularies published by IHE, such as FormatCode vocabulary used in FHIR DocumentReference, and the various IHE XDS family?

  3. Hello John MoehrkeI'm not an IHE expert by any means, so I have asked about....My understanding is that IHE doesn't "author" terminology, it references terminology that other SDOs etc. provide. FormatCode is (I think) in the  metadata section and there it says "Where codes are selected for a metadata attribute, they need to be very clearly defined and should express the cases where the code should be used. Clear and specific definitions of vocabulary are critical to success. Look at international terminologies (LOINC, SNOMED), national extensions, IHE profiles, professional society
    recommendation, and other Implementation Guides".  So I don't think there is "IHE vocabularies" per se.  So I think you have to choose the code system for your value set and then, if it's not one we've already sorted, we can help you (smile)

    1. Hi Julie James

      It is true that IHE is mostly a user of terminology. But sometimes they do author terminology.  So it is very understandable that you have the perception that they don't author terminologies.  In fact the governance of IHE is intentionally skewed to the use of standards. However as with any rule, there are exceptions.

      The FormatCode vocabulary is one of these exceptions.  These are not overlapping with LOINC or SNOMED. These are codes that identify the IHE Profile that has defined that specific set of document constraints. Thus there is a vocabulary from IHE here. Note that the existing codes in FHIR are pulled from the IHE FTP site. This IHE FTP site is going to be shutdown this week. Thus there is urgency to resolving this to continue to enable the development toward FHIR R5.

      I am the FormatCode vocabulary librarian within IHE.  The effort is a collaborative effort of all the workgroup/domains within IHE to support one unified vocabulary from IHE.

      Here is the draft of the IG publishing the FormatCode vocabulary from IHE authorship. It will soon be moved to a formal publication location and registered with canonical URI.

      Further the valueSet used in FHIR DocumentReference.content.format  will become a combination of IHE, DICOM, and HL7 codes for FormatCode use. We are trying to transition to formal management. I implore you to help us on this.

      Grahame Grieve do you have any advice or emphasis you can add?

      There are other cases beyond FormatCode that are not as critical to FHIR, so I am not pushing them at this point. Many of them will be published within the context of the Implementation Guide in which they are used, and thus not needing broader exposure.


  4. Hello John Moehrke

    I'll try to put what you've said into my words, to see if I understand....

    There is a set of concepts that form a "code system" (Core Principles definition) for which IHE is the authorised maintenance organisation (again, Core Principles definition).  The domain for that code system is an IHE Profile set of document constraints and the code system is called " IHE Format Code".  Unfortunately, the authorised maintenance organisation for this code system is about to shut down their access to it, and therefore any existing (canonical) URL/URI for it effectively disappears.  However, the authorised maintenance organisation is setting up a new canonical URL for this code system at  I notice this is FHIR IG location rather than an IHE location, but if IHE is happy with that, I don't think the HTA would be concerned.  If and how this might be managed in UTG, I am not sure though.  

    Building a value set with concepts from several code systems, whilst not necessarily ideal, is of course common practice, and I don't anticipate would be any different for the FHIR DocumentReference.content.format than for any other value set, would it?  It would use the new canonical URL to reference the IHE Format Codes and the existing URLs for the HL7 codes and the existing authorised DICOM one (

    We can set up a page for you to fill for the IHE Format Code (Code) System on our External Terminologies Confluence section and to put in the new canonical URL.  

    Does that fulfil the help you need for formal management? And apologies if I have misunderstood....

    1. Hi Julie James

      Yes, I think you have captured the essence.

      Just want to emphasize that I am speaking as the liaison from IHE, the one authorized by IHE to reach out to HTA on this matter. So this is not a request simply of an HL7 member asking that HTA reach to IHE. This is IHE reaching out to HTA to be recognized.

      The content I pointed at is draft to show you that IHE is ready to open this discussion. That is not the final URL. The final URL will hopefully be available later this week.


      1. John Moehrke Stub has been created. I filled in some basics, please let us know if you have any questions. Once this page is completed, we will communicate and publicize it's creation to both the Implementer and Terminology zulip threads.

        Integrating the Healthcare Enterprise (IHE) Format Code

        Thank you for the proactive reach out on IHE's behalf.

        1. I see the page. Do you want me to fill the content? Most of it is already in our FHIR CodeSystem resource, which is rendered in draft form in the IG


          1. Got it. I've taken a pass through, including information from the FHIR Code System resource. Please take a look and edit whereever necessary. I wasn't sure what to put in for versioning.

            1. note that this is not the ONLY vocabulary from IHE. It is just the first that is needed in the HTA terminology services. 

              1. Understood.  If and when you need pages for those code systems, we're happy to add them.  We are trying to be pro-active (I have a spreadsheet that Grahame produced from some FHIR artefacts) but it takes a while to work through, as you can imagine - 1800+ lines.  FormatCode is on it....but searching for "IHE" the only other one that I can find is "endpoint-payload-type".  

  5. Hi John Moehrke 

    Yes, from your second comment, I did "twig" that you were reaching out formally as authorised by IHE as the code system "owner"; I'm apologise I didn't appreciate that from your first comment.  So, to echo Carol's comment, thank you very much indeed for reaching out proactively, and apologies again that I didn't grasp that from the very beginning.