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Page 136​

DICOM PS3.3 2020a - Information Object Definitions​

Note​

The instruction "Include Table 8.8-1 “Code Sequence Macro Attributes” " may be used in an Information Object Definition​ asaconcisewaytoindicatethattheAttributesofTable8.8-1areincludedinthespecificationoftheAttributeSetofaSequence​ of Items. Additional constraints on the Code Sequence Data Element (such as a Context Group that defines the value set)​ may be appended to the "Include Table 8.8-1 “Code Sequence Macro Attributes” " instruction.​

The default specifications of this Section are overridden within the scope of a Sequence Item or Code Sequence Attribute or IOD by​ corresponding specifications defined within the scope of that Sequence Item or Code Sequence Attribute or IOD. Additional Attributes​ may also be specified by the instantiation of the Macro.​

The Basic Coded Entry Attributes fully define a Coded Entry. If it is desired to convey the list from which a code has been chosen,​ then the optional Enhanced Encoding Mode Attributes may also be present.​

Table 8.8-1a. Basic Code Sequence Macro Attributes​

Attribute Name​

Tag​

Type​

Attribute Description​

BASIC CODED ENTRY ATTRIBUTES​

 

 

Code Value​

(0008,0100)​

1C​

The identifier of the Coded Entry.​

 

 

 

See Section 8.1.​

 

 

 

Shall be present if the code value length is 16 characters or less, and​

 

 

 

the code value is not a URN or URL.​

Coding Scheme​

(0008,0102)​

1C​

The identifier of the coding scheme in which the Coded Entry is defined.​

Designator​

 

 

See Section 8.2.​

 

 

 

 

 

 

Shall be present if Code Value (0008,0100) or Long Code Value​

 

 

 

(0008,0119) is present. May be present otherwise.​

Coding Scheme Version​

(0008,0103)​

1C​

An identifier of the version of the coding scheme if necessary to resolve​

 

 

 

ambiguity.​

 

 

 

See Section 8.2. Required if the value of Coding Scheme Designator​

 

 

 

(0008,0102) is present and is not sufficient to identify the Code Value​

 

 

 

(0008,0100)orLongCodeValue(0008,0119)unambiguously.Shallnot​

 

 

 

be present if Coding Scheme Designator (0008,0102) is absent. May​

 

 

 

be present otherwise.​

Code Meaning​

(0008,0104)​

1​

Text that conveys the meaning of the Coded Entry.​

 

 

 

See Section 8.3.​

Long Code Value​

(0008,0119)​

1C​

The identifier of the Coded Entry.​

 

 

 

See Section 8.1.​

Shall be present if Code Value (0008,0100) is not present and the Code​

Value is not a URN or URL.​

URN Code Value​

(0008,0120)​

1C​ The identifier of the Coded Entry.​

See Section 8.1.​

Shall be present if Code Value (0008,0100) is not present and the Code​

Value is a URN or URL.​

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DICOM PS3.3 2020a - Information Object Definitions​ Page 137​

Table 8.8-1b. Enhanced Code Sequence Macro Attributes​

Attribute Name​

Tag​

Type​

Attribute Description​

Context Identifier​

(0008,010F)​

3​

The identifier of the Context Group from which the Coded Entry was​

 

 

 

selected.​

 

 

 

See Section 8.6.​

Context UID​

(0008,0117)​

3​

The unique identifier of the Context Group from which the Coded Entry​

 

 

 

was selected.​

 

 

 

See Section 8.6.​

Mapping Resource​

(0008,0105)​

1C​

The identifier of the Mapping Resource that defines the Context Group​

 

 

 

from which Coded Entry was selected.​

 

 

 

See Section 8.4. Required if Context Identifier (0008,010F) is present.​

Mapping Resource UID​

(0008,0118)​

3​

The unique identifier of the Mapping Resource that defines the Context​

 

 

 

Group from which Coded Entry was selected.​

 

 

 

Note​

 

 

 

TheuniqueidentifierfortheDICOMContentMappingResource​

 

 

 

"DCMR" is defined in PS3.6.​

Mapping Resource Name​

(0008,0122)​

3​

ThenameoftheMappingResourcethatdefinestheContextGroupfrom​

 

 

 

which Coded Entry was selected.​

 

 

 

See Section 8.4.​

Context Group Version​

(0008,0106)​

1C​

The identifier of the version of the Context Group from which the Coded​

 

 

 

Entry was selected.​

 

 

 

See Section 8.5.​

 

 

 

Required if Context Identifier (0008,010F) is present.​

Context Group Extension​

(0008,010B)​

3​

Indicates whether the triplet of Code Value (0008,0100) (or Long Code​

Flag​

 

 

Value (0008,0119) or URN Code Value (0008,0120))/Coding Scheme​

 

 

 

Designator (0008,0102)/Code Meaning (0008,0104) is selected from a​

 

 

 

private extension of the Context Group identified in Context Identifier​

 

 

 

(0008,010F). See Section 8.7.​

 

 

 

Enumerated Values:​

 

 

 

Y​

 

 

 

N​

Context Group Local​

(0008,0107)​

1C​

An implementation-specific version of a Context Group that contains​

Version​

 

 

private extensions.​

 

 

 

See Section 8.7. Required if the value of Context Group Extension Flag​

 

 

 

(0008,010B) is "Y".​

Context Group Extension​

(0008,010D)​

1C​

Identifies the person or organization who created an extension to the​

Creator UID​

 

 

Context Group. See Section 8.7.​

Required if the value of Context Group Extension Flag (0008,010B) is​ "Y".​

Table 8.8-1. Code Sequence Macro Attributes​

Attribute Name​

Tag​

Type​

Attribute Description​

BASIC CODED ENTRY ATTRIBUTES​

 

 

 

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DICOM PS3.3 2020a - Information Object Definitions​

Attribute Name​

Tag​

Type​

Attribute Description​

Include Table 8.8-1a​

 

 

 

Equivalent Code Sequence​

(0008,0121)​

3​

Codes that are considered equivalent by the​

 

 

 

creating system.​

One or more Items are permitted in this​

Sequence.​

See Section 8.9.​

>Include Table 8.8-1a​

>Include Table 8.8-1b​

ENHANCED ENCODING MODE​

Include Table 8.8-1b​

8.9 Equivalent Code Sequence​

The Equivalent Code Sequence (0008,0121) Attribute may optionally be used to convey different codes for the same concept.​

Equivalence is defined as having the same or similar meaning, and requires that equivalent concepts do not include different aspects,​ properties, features, characteristics, or parameters.​

Note​

E.g., the SNOMED and FMA codes for a structure of the breast, (76752008, SCT, "Breast") and (57983, FMA, "Breast")​ would be considered equivalent. Neither would be equivalent to concepts that pre-coordinated other aspects such as later-​ ality, e.g., (80248007, SCT, "Left breast"), or entire body organ, e.g., (181131000, SCT, "Entire breast").​

Some scenarios in which it is helpful for the creating system to send equivalent codes include:​

•​when different representations of the same concept are present in a standard coding scheme, such as the SNOMED-CT and​ SNOMED-RT and CTV3 style identifiers,​

•​when the same concept is present in different standard coding schemes, but considered by the creating system to be synonymous,​ such as anatomical concepts from SNOMED and FMA, and​

•​when the same concept is present in a local as well as a standard coding scheme, but considered by the creating system to be​ synonymous, such as a local private procedure code and the same concept in LOINC or SNOMED or RADLEX.​

The Table 8.8-1b may be used to identify a Context Group from which the codes were selected, such as for a particular cross-institu-​ tional, cross-application context for trials, research and knowledge-based applications.​

8.10 Coded Entry Data Examples​

An example of a long SNOMED CT code encoding as an Item in a Sequence:​

Nesting​

Attribute Name​

Tag​

VR​

Value​

%item​

 

 

 

 

>​

Coding Scheme Designator​

(0008,0102)​

SH​

SCT​

>​

Code Meaning​

(0008,0104)​

LO​

Invasive diagnostic procedure​

>​

Long Code Value​

(0008,0119)​

UC​

621566751000087104​

%enditem​

 

 

 

 

Note​

SCT:621566751000087104 is not included in the SNOMED CT DICOM Subset and is not present in the SNOMED CT INT​ release. It is from the Canadian National Extension and is used here only as an example.​

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DICOM PS3.3 2020a - Information Object Definitions​

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An example of a short SNOMED CT with equivalent SNOMED SRT and CTV3 (Read) codes as an Item in a Sequence:​

Nesting​

Attribute Name​

Tag​

VR​

Value​

%item​

 

 

 

 

>​

Code Value​

(0008,0100)​

SH​

406400000​

>​

Coding Scheme Designator​

(0008,0102)​

SH​

SCT​

>​

Code Meaning​

(0008,0104)​

LO​

Dimeglumine gadopentetate​

 

 

 

 

469.01mg/mL inj soln 15mL pfld​

 

 

 

 

syr​

>​

Equivalent Code Sequence​

(0008,0121)​

SQ​

 

%sequence​

 

 

 

 

%item​

 

 

 

 

>>​

Code Value​

(0008,0100)​

SH​

C-B0478​

>>​

Coding Scheme Designator​

(0008,0102)​

SH​

SRT​

>>​

Code Meaning​

(0008,0104)​

LO​

Dimeglumine gadopentetate​

 

 

 

 

469.01mg/mL inj soln 15mL pfld​

 

 

 

 

syr​

%enditem​

 

 

 

 

%item​

 

 

 

 

>>​

Code Value​

(0008,0100)​

SH​

XUaZB​

>>​

Coding Scheme Designator​

(0008,0102)​

SH​

CTV3​

>>​

Code Meaning​

(0008,0104)​

LO​

Dimeglumine gadopentetate​

 

 

 

 

469.01mg/mL inj soln 15mL pfld​

 

 

 

 

syr​

%enditem​ %endseq​ %enditem​

Note​

SCT:406400000 is not included in the SNOMED CT DICOM Subset and is used here only as an example.​

An example of encoding a long URN as an Item in a Sequence.​

 

Nesting​

Attribute Name​

Tag​

VR​

Value​

%item​

 

 

 

 

>​

Code Meaning​

(0008,0104)​

LO​

HIPAA Privacy Rule​

>​

URN Code Value​

(0008,0120)​

UR​

urn:lex:us:federal:codified.regulation:2013-04-25;45CFR164​

%enditem​

 

 

 

 

8.11 Retired Codes and Expected Behavior​

As this Standard and external coding schemes are maintained, the codes specified as Values for Attributes and in Conditions may​ change. The previous codes are considered Retired but implementations may continue to send them and receivers will be expected​ to be able to continue to recognize the Retired codes, including the Code Value and Coding Scheme Designator, even if the current​ Standard does not publish them.​

A notable example is the change throughout the Standard from using "SNOMED-RT style" code values with a Coding Scheme Des-​ ignator of "SRT", "SNM3" or "99SDM", to the use of SNOMED CT numeric code values with a Coding Scheme Designator of "SCT".​ Those retired codes may be found in PS3.3 2019a. A mapping of retired to new SNOMED codes is found in Annex O “SNOMED​ Concept ID to SNOMED ID Mapping” in PS3.16.​

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DICOM PS3.3 2020a - Information Object Definitions​

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