SNOMED International is doing analysis and collection of input from experts in the area of angiography. Part of this work has confirmed that the procedures computed tomography angiography and fluoroscopic angiography always use contrast. As a result of this there will be a need to make some changes to 418272005 |Computed tomography angiography (procedure)| and subtypes as well as 420040002|Fluoroscopic angiography (procedure)| and subtypes. This will impact 866 concepts (current as of the Jan 2020 release). The changes proposed are:

• The addition of 424361007 |Using substance (attribute)|=385420005 |Contrast media (substance)| in the relationship group
• Change to the FSN e.g. 418272005|Computed tomography angiography (procedure) to 418272005|Computed tomography angiography with contrast (procedure)
• Inactivation of any equivalence e.g. 241553009 |Computed tomography of abdominal aorta (procedure)| will be the same as 444968003 |Computed tomography of abdominal aorta with contrast (procedure). Where this occurs the concept which explicitly states "with contrast" would be the concept that is remains active.

Prior to undertaking this work the issue of whether this change should be considered "substantive" enough to require inactivation and replacement of the concepts impacted is being considered.

To support determining this the CMAG is being asked would implementers view the change detailed above as a substantive enough that the inactivation and replacement should be undertaken. Please provide feedback in this forum before EOD April 8.
Thank you!