DICOM PS3.16 2021b - Content Mapping Resource

8 Coding Schemes (Current)
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# 8 Coding Schemes

Table 8-1 lists the coding schemes (and their designators) defined for use in DICOM; Table 8-2 lists the HL7v3 coding schemes referenced for use in DICOM. Additionally, any coding scheme may be used that has an entry in the HL7 Registry of Coding Schemes (HL7 v2 Table 0396, or the equivalent online registry), in which case the HL7 Symbolic Name shall be used as the value for the Coding Scheme Designator in DICOM, as long as it does not conflict with an entry Table 8-1 and fits within the Value Representation of the DICOM Coding Scheme Designator (0008,0102) attribute. As specified in the HL7 v2 Table 0396, local or private coding schemes shall be identified by an alphanumeric identifier beginning with the characters "99".

### Note

1. An earlier version of this table was formerly contained in Annex D of PS3.3.

2. See Section 8.2 “Coding Scheme Designator and Coding Scheme Version” in PS3.3 for further description.

3. The Coding Scheme UIDs are provided for reference only; the normative specification of UIDs and their associated meaning is the responsibility of the coding scheme developer and/or HL7.

4. The current version of HL7 v2 Table 0396 is available at http://www.hl7.org/special/committees/vocab/table_0396/index.cfm.

5. The HL7 registration of Coding Schemes is available at http://www.hl7.org/oid/index.cfm.

6. Publication of codes or references to coding schemes within DICOM does not constitute a grant of intellectual property rights to implementers. Use of some Coding Schemes may require a license, or purchase of the relevant coding scheme publication. Implementers should consult the relevant coding scheme publisher; see also Section 2.

7. The values of Coding Scheme Name (0008,0115), Coding Scheme Responsible Organization (0008,0116) and Coding Scheme Resources Sequence (0008,0109), if available, may be used to fill the corresponding optional attributes of the Coding Scheme Identification Sequence (0008,0110) in the Section C.12.1 “SOP Common Module” in PS3.3 .

Table 8-1. Coding Schemes

Coding Scheme Designator (0008,0102) | Coding Scheme UID (0008,010C) | Coding Scheme Name (0008,0115) | Coding Scheme Responsible Organization (0008,0116) | Coding Scheme Resources Sequence (0008,0109) Type: URL | Description
--- | --- | --- | --- | --- | ---
ACR | 2.16.840.1.​113883.6.76 | ACR Index | ACR |  | ACR Index for Radiological Diagnosis Revised, 3rd Edition 1986
ASTM-sigpurpose | 1.2.840.10065.​1.12 | ASTM E 2084 | ASTM |  | [ASTM E 2084-00] Signature Purpose codes (see Annex A1 of ASTM E 2084), ASTM Subcommittee E 31.20 Data and System Security for Health Information
BARI |  | BARI |  |  | Bypass Angioplasty Revascularization Investigation[Alderman 1992]; endorsed by ACC/AHA Guidelines for Coronary Angiography[Scanlon 1999].
BI |  | BI-RADS | ACR |  | ACR Breast Imaging Reporting and Data System [BI-RADS®], Coding Scheme Version (0008,0103) is required; code values are section and paragraph identifiers within the publication where the code meaning is defined (e.g., "I.D.1", where I = Breast Imaging Lexicon, D = Special Cases, 1 = Tubular Density, as the code value for "Tubular Density"). ### Note In the HL7 registry, the abbreviation BI is assigned to a different coding scheme, specifically the Beth Israel problem list.
C4 | 2.16.840.1.​113883.6.12 | CPT-4 | AMA |  | American Medical Association's Current Procedure Terminology 4 (CPT-4)
C5 | 2.16.840.1.​113883.6.82 | CPT-5 | AMA |  | American Medical Association's Current Procedure Terminology 5 (CPT-5)
caDSR | 2.16.840.1.113883.3.26.2 | Cancer Data Standard Repository | NCI |  | The Public ID is used as the Code Value. These can be looked up as in the following example (the version is required): http://​cdebrowser.​nci.​nih.​gov/​CDEBrowser/​search?​dataElementDetails​=​9/​&cdeId=2178693&​version=2.1​&​PageId​=DataElementsGroup
CD2 | 2.16.840.1.​113883.6.13 | CDT-2 | ADA |  | American Dental Association's (ADA) Current Dental Terminology 2 (CDT-2)
CTV3 | 2.16.840.1.​113883.6.6 | Clinical Terms Version 3 | UK NHS |  | Read Codes
DC | 1.2.840.10008.​2.​16.​10 | Dublin Core | W3C | DOC: http://​dublincore.​org/​documents/​1998/​09/​dces/ DOC: http://​www.​ietf.​org/​rfc/​rfc2413.txt | Dublin Code Metadata for Resource Discovery. The code value is the Label field, e.g., "Creator" (capitalization significant).
DCM | 1.2.840.10008.​2.16.4 | DICOM Controlled Terminology | DICOM | DOC: http://​dicom.​nema.​org/​medical/​dicom/​current/​output/​chtml/​part16/​chapter_D.html OWL: ftp://​medical.​nema.​org/​medical/​dicom/​current/​ontology/​dcm.owl.zip | PS3.16 Content Mapping Resource, Annex D (Note that HL7 also specifies an OID of 2.16.840.1.​113883.6.31, but deprecates it in favor of 1.2.840.10008.​2.16.4).
DCMUID | 1.2.840.10008.​2.6.1 | DICOM UID Registry | DICOM | DOC: http://​dicom.​nema.​org/​medical/​dicom/​current/​output/​chtml/​part06/​chapter_A.html |
FMA | 2.16.840.1.​113883.6.119 | FMA | University of Washington, Seattle | DOC: http://​sig.​biostr.​washington.​edu/​projects/​fm/​AboutFM.​html OWL: http://​sig.​biostr.​washington.​edu/​share/​downloads/​fma/​release/​latest/​fma.​zip | Digital Anatomist Foundational Model of Anatomy
HPC | 2.16.840.1.​113883.6.14 |  |  |  | Healthcare Financing Administration (HCFA) Common Procedure Coding System (HCPCS)
I10 | 2.16.840.1.​113883.6.3 | ICD-10 | WHO |  | International Classification of Diseases revision 10 (ICD-10)
I10P | 2.16.840.1.​113883.6.4 | ICD-10-PCS | US DHHS CMS |  | ICD-10 Procedure Coding System (ICD 10 PCS)
I11 | 1.2.840.​10008.2.​16.​16 | ICD-11 | WHO | DOC: http://​icd.who.int/​browse11/​l-m/​en | International Classification of Diseases revision 11 (ICD-11)
I9 | 2.16.840.1.​113883.6.42 | ICD-9 | WHO |  | International Classification of Diseases revision 9 (ICD-9)
I9C | 2.16.840.1.​113883.6.2 | ICD-9-CM |  |  | International Classification of Diseases revision 9, with Clinical Modifications (ICD-9-CM)
IBSI | 1.2.840.10008.2.​16.​13 | Image Biomarker Standardisation Initiative |  | DOC: http://​arxiv.org/​abs/​1612.07003 |
IETF4646 |  | RFC 4646 | IETF | DOC: http://​tools.​ietf.​org/​html/​rfc4646 | [RFC 4646], Tags for Identifying Languages, The Internet Society (2005) [RFC 4646] has been superceded by [RFC 5646].
ISO639_1 | 2.16.840.1.​113883.6.99 | ISO 639-1 | ISO |  | [ISO 639-1] Two-letter language codes ### Note HL7 uses "ISO639-1" for the symbolic name, with a hyphen rather than an underscore
ISO639_2 | 2.16.840.1.​113883.6.100 | ISO 639-2 | ISO |  | [ISO 639-2] Three-letter language codes ### Note HL7 uses "ISO639-2" for the symbolic name, with a hyphen rather than an underscore
ISO3166_1 | 2.16.1 | ISO 3166-1 | ISO |  | [ISO 3166-1] alpha-2 Country Codes ### Note HL7 uses "ISO3166-1" for the symbolic name, with a hyphen rather than an underscore
ISO5218_1 |  | ISO 5218-1 | ISO |  | Representation of Human Sexes (not used) ISO5218_1, which uses numeric codes, was improperly specified in CID 7455 Sex in earlier editions of the Standard. The alphabetic codes improperly attributed to that coding scheme have been added to the DICOM Controlled Terminology, and thus all references to coding scheme ISO5218_1 should be considered equivalent to coding scheme DCM.
ISO_OID |  | ISO OID | ISO |  | [ISO 8824-1] ISO/IEC 8824-1- Information Technology - Abstract Syntax 1 (ASN.1): Specification of Basic Notation, and [ISO 9834-1] - Information technology - Open Systems Interconnection - Procedures for the operation of OSI Registration Authorities: General procedures and top arcs of the ASN.1 Object Identifier tree
ITIS_TSN | 1.2.840.10008.​2.​16.​7 | ITIS TSN | ITIS | DOC: http://​www.​itis.​gov | A Taxonomic Serial Number (TSN) is a unique, persistent, non-intelligent identifier for a scientific name in the context of the Integrated Taxonomic Information System (ITIS).
LN | 2.16.840.1.​113883.6.1 | LOINC | Regenstrief Institute | DOC: http://​loinc.​org/ | [LOINC] Logical Observation Identifier Names and Codes
MA | 1.2.840.10008.​2.​16.​5 | Adult Mouse Anatomy Ontology | The Jackson Laboratory | DOC: http://​www.​informatics.​jax.​org/​searches/​AMA.​cgi?​id=MA:0002405 | Hayamizu TF, Mangan M, Corradi JP, Kadin JA, Ringwald M. The Adult Mouse Anatomical Dictionary: a tool for annotating and integrating data. Genome Biology 2005;6(3):R29. doi:10.1186/gb-2005-6-3-r29. http://​www.​ncbi.​nlm.​nih.​gov/​pmc/​articles/​PMC1088948/
MAYOASRG | 1.2.840.​10008.2.​16.​12 | Mayo Clinic Non-radiological Images Specific Body Structure Anatomical Surface Region Guide |  |  | The numeric code of entries in the Mayo Clinic Non-radiological Images Specific Body Structure Anatomical Surface Region Guide.
MDC | 2.16.840.1.​113883.6.24 |  |  |  | ISO/IEEE 11073 Medical Device Nomenclature, including all its subsections ([ISO/IEEE 11073-10101], [ISO/IEEE 11073-10101a], [ISO/IEEE 11073-10102], etc.), encoded as decimal strings <partition>:<element>
MDNS |  |  |  |  | Universal Medical Device (UMD) Nomenclature System
MGI | 1.2.840.10008.​2.​16.​8 | MGI | The Jackson Laboratory | DOC: http://​www.​informatics.​jax.​org/​mgihome/​nomen/ | The MGI ID from the Mouse Genome Initiative (MGI) nomenclature.
MSH | 2.16.840.1.​113883.6.177 | MeSH | NLM | DOC: http://​www.​nlm.​nih.​gov/​mesh/​meshhome.​html | US National Library of Medicine (NLM) Medical Subject Headings (MeSH)
NBD | 2.16.840.1.​113883.15.2 |  |  |  | NASPE/BPEG Defibrillator Code Bernstein AD, et al."The NASPE/BPEG Defibrillator Code" PACE, 16:1776-1780, 1993
NBG | 2.16.840.1.​113883.15.3 |  |  | DOC: http://www.​hrsonline.​org/​Practice-​Guidance/​Clinical-​Guidelines-​Documents/​2002-​The-​Revised-​NASPE-​BPEG​-​Generic-​Code-​for-​Antibradycardia-​​AdaptiveRate-​and-​Multisite-​Pacing | NASPE/BPEG Generic Pacemaker Code (2000) Bernstein AD, et al."The Revised NASPE/BPEG Generic Code for antibradycardia, adaptive-rate, and multisite pacing." Pacing Clin Electrophysiol., 25:260-264, 2002 See http://​www.​hrsonline.​org/​Practice-​Guidance/​Clinical-​Guidelines-​Documents/​2002-​The-​Revised-​NASPE-​BPEG​-​Generic-​Code-​for-​Antibradycardia-​​AdaptiveRate-​and-​Multisite-​Pacing.
NCDR |  |  |  |  | American College of Cardiology National Cardiovascular Data Registry™ Cath Lab Module Version 1.1, 1997; Version 2.0b, 1999
NCIt | 2.16.840.1.​113883.3.26.1.1 | NCI Thesaurus | NCI | DOC: http://​ncit.​nci.​nih.​gov/ |
NDC | 2.16.840.1.113883.6.69 | National Drug Code Directory | US FDA | DOC: http://​www.fda.gov/​Drugs/​Information​​OnDrugs/​ucm142438.htm DOC: http://​www.hl7.org/​fhir/​ndc.html | The code value is the 10 digit 3 segment NDC code with "-" between segments included and no asterisk (leading zero placeholder).
NEU | 2.16.840.1.​113883.6.210 | NeuroNames |  | DOC: http://​braininfo.​rprc.​washington.​edu​/aboutBrainInfo.​aspx​#NeuroNames | The numeric brainInfoID is used as the code value. See
NICIP | 2.16.840.1.​113883.2.1.​3.2.4.21 | NICIP | UK NHS | DOC: http://​digital.​nhs.​uk/​article/​1108/​National-​Interim-​Clinical-​Imaging-​Procedure-​NICIP-​Code-​Set | UK National Health Service National Interim Clinical Imaging Procedures (NICIP) Short Code (e.g., "CCHAPC" for CT Thorax abdomen pelvis with contrast)
NPI |  |  |  |  | HCFA National Provider Identifier
NYUMCCG | 1.2.840.​10008.2.​16.​11 | New York University Melanoma Clinical Cooperative Group |  | DOC: http://​www.anatomymapper.com/​nyu/ | The numeric code of entries in the New York University Melanoma Clinical Cooperative Group's numbering system.
PATHLEX | 1.3.6.1.4.1.​19376.1.8.2.1 | PathLex | IHE | DOC: http://​www.ihe.net/​Technical​_Framework/​upload/​IHE​_PAT​_Suppl​_APSR​_Appendix​_Value​_Sets​_2011_03_31​.xls DOC: http://​purl.bioontology.org/​ontology/​PATHLEX | The numeric pathLexCode is used as the code value.
POS | 2.16.840.1.​113883.6.50 |  |  |  | HCFA Place of Service (POS) Codes for Professional Claims
PUBCHEM_CID | 1.2.840.10008.​2.​16.​9 | PubChem | NCBI | DOC: http://​pubchem.​ncbi.​nlm.​nih.​gov/ | US National Center for Biotechnology Information (NCBI) PubChem Compound CID.
RADLEX | 2.16.840.1.​113883.6.256 | RadLex | RSNA | DOC: http://​www.radlex.org/ | [RadLex]
RADELEMENT | 1.2.840.10008.2.​16.​15 | RadElement | RSNA | DOC: http://radelement.org/ | [RadElement]
RFC3066 | 2.16.840.1.​113883.6.121 | RFC 3066 | IETF | DOC: http://​tools.ietf.org/​html/​rfc3066 | [RFC 3066], Tags for the Identification of Languages, Internet Engineering Task Force ### Note HL7 uses "IETF3066" for the symbolic name. [RFC 3066] has been superseded by [RFC 4646], which in turn has been superceded by [RFC 5646].
RFC-3881 |  | RFC 3881 | IETF | DOC: http://​tools.ietf.org/​html/​rfc3881 | [RFC 3881], Security Audit and Access Accountability Message - XML Data Definitions for Healthcare Applications ### Note A hyphen is used in the Coding Scheme Designator for consistency with historical use in IHE. See IHE ITI TF Vol2a. Section 3.20.7.1.3.
RFC5646 | 2.16.840.1.​113883.6.316 | RFC 5646 | IETF | DOC: http://​tools.ietf.org/​html/​rfc5646 | [RFC 5646], Tags for Identifying Languages, The Internet Society (2009) ### Note The HL7 OID Registry specifies "rfc5646", not "ietf5646", as the Desired Symbolic Name (inconsistent with the pattern used for [RFC 4646]). [RFC 5646] constitutes one part of IETF Best Current Practice BCP 47 Tags for Identifying Languages, which also includes [RFC 4647] Matching of Language Tags; [RFC 4647] is not relevant in this context.
RO | 1.2.840.​10008.​2.​16.​14 | Radiomics Ontology |  | DOC: http://​bioportal.bioontology.org/​ontologies/​RO |
RXNORM | 2.16.840.1.113883.6.88 | RXNORM | NLM | DOC: http://​www.nlm.nih.gov/​research/​umls/​rxnorm/ | RxNorm provides normalized names for clinical drugs and links its names to many of the drug vocabularies commonly used in pharmacy management and drug interaction software.
99SDM | 2.16.840.1.​113883.6.53 | SDM | DICOM |  | SNOMED DICOM Microglossary (Retired) (see Section 8.1)
SCPECG |  |  |  |  | Standard Communications Protocol for Computer-Assisted Electrocardiography, Draft proposal for ISO Standard, AAMI, Revision 1.3
SNM3 | 2.16.840.1.​113883.6.51 | SNOMED V3 | SNOMED International | DOC: http://​www.snomed.org/ | SNOMED International Version 3 (see Section 8.1) ### Note This coding scheme is deprecated. The use of "SNOMED-RT style" code values is no longer authorized by SNOMED except for creation by legacy devices, legacy objects in archives, and receiving systems that need to understand them.
SCT | 2.16.840.1.​113883.6.96 | SNOMED CT | SNOMED International | DOC: http://​www.snomed.org/ | [SNOMED], using the CT code values
SRT | 2.16.840.1.​113883.6.96 | SNOMED CT | SNOMED International | DOC: http://​www.snomed.org/ | [SNOMED], using the "SNOMED-RT style" code values (see Section 8.1) ### Note HL7 uses "SNM" for the symbolic name. This coding scheme is deprecated. The use of "SNOMED-RT style" code values is no longer authorized by SNOMED except for creation by legacy devices, legacy objects in archives, and receiving systems that need to understand them.
UBERON | 1.2.840.10008.​2.​16.​6 | UBERON |  | DOC: http://​uberon.org/ | The Uberon ID from the Uberon integrated cross-species ontology covering anatomical structures in animals.
UCUM | 2.16.840.1.​113883.6.8 | UCUM | Regenstrief Institute | DOC: http://​unitsofmeasure.org/​ucum.html | [UCUM] Unified Code for Units of Measure
UMLS | 2.16.840.1.​113883.6.86 | UMLS | NLM | DOC: http://​www.nlm.nih.gov/​research/​umls/ | UMLS codes as CUIs making up the values in a coding system
UPC | 2.16.840.1.​113883.6.55 |  |  |  | Universal Product Code - Universal Code Council

Table 8-2. HL7v3 Coding Schemes

Coding Scheme Designator | Coding Scheme UID | Description
--- | --- | ---
ActCode | 2.16.840.1.113883.5.4 |
ActPriority | 2.16.840.1.113883.5.7 |
AdministrativeGender | 2.16.840.1.113883.5.1 |
mediaType | 2.16.840.1.113883.5.79 | RFC2046
NullFlavor | 2.16.840.1.113883.5.1008 |
ObservationInterpretation | 2.16.840.1.113883.5.83 |
Confidentiality | 2.16.840.1.113883.5.25 |
ParticipationType | 2.16.840.1.113883.5.90 |

## 8.1 SNOMED CT

SNOMED (the Systematized Nomenclature of Medicine) Clinical Terms (CT) is the preferred coding system within DICOM for anatomy, clinical findings, procedures, pharmaceutical/biologic products (including contrast agents), and other clinical terms.

SNOMED has had various versions, including SNOMED International (Version 3), which was issued in 1993 and revised through 1998, SNOMED Reference Terminology, the successor to SNOMED 3 that was published between 1999 and 2001, and SNOMED Clinical Terms, which has been the name since 2002. The coding scheme is fully backward-compatible across SNOMED 3, SNOMED-RT, and SNOMED CT. SNOMED CT introduced a solely numeric set of codes (ConceptID) in addition to the former alphanumeric codes (SnomedID), but all SNOMED terminology concepts have both a numeric and an alphanumeric code.

In previous editions of the DICOM Standard, the following Coding Scheme Designators were used for SNOMED codes in DICOM:

- "99SDM", denoting the provisional SNOMED DICOM Microglossary

- "SNM3", denoting SNOMED International (Version 3)

- "SRT", originally denoting SNOMED-RT, but later used to identify SNOMED CT concepts using "SNOMED-RT style" alphanumeric code values

All uses of SNOMED CT coded terms in DICOM are now indicated by the Coding Scheme Designator "SCT", identifying them as SNOMED CT numeric Concept IDs as code values.

When a Coding Scheme Designator of "99SDM", "SNM3" or "SRT" is encountered by a receiving system, the "SNOMED-RT style" alphanumeric Code Value needs to be mapped to the corresponding concept designated by the SNOMED CT Concept IDs assigned to the same concept.

### Note

"SRT" as a coding scheme designator was used only in the DICOM Standard. HL7v2 did not standardize a coding scheme designator for SNOMED-RT.

When interoperating with systems that use SNOMED CT codes, Application Entities may receive and are expected to send Code Sequences with a numeric ConceptID code. It is the responsibility of such Application Entities to convert any alphanumeric SnomedID with Coding Scheme Designator "SRT" used in old DICOM objects and services to the corresponding numeric ConceptID code.

### Note

1. Some non-DICOM systems may use a Coding Scheme Designator of "SNOMED-CT" rather than "SCT" as is used in DICOM.

2. The SNOMED organization's policy on the use of "antecedent versions", including the continued use of "SNOMED-RT style" alphanumeric code values is described at: http://​www.snomed.org/​news-articles/​timetable-​for-​the-​withdrawal-​of-​legacy-​snomed-​codes.

3. Since the SNOMED organization no longer distributes a reference set that includes a mapping of "SNOMED-RT style" SNOMED IDs to SNOMED Concept IDs a complete mapping of those used in DICOM is provided in Annex O to allow implementers to process legacy objects from legacy devices and archives.

### 8.1.1 Use of SNOMED Anatomic Concepts

In general, DICOM uses the anatomic concepts with the term "structure", rather than with the term "entire". This is an important distinction in SNOMED. "Entire" is a child concept to "structure", has a more restricted meaning, and typically is used in conjunction with treatments (e.g., "excision of entire right kidney"). It is used in distinction to other sibling children of the parent concept that may identify parts of the parent anatomic feature. Since imaging typically targets both the anatomic feature and the area around it, or sometimes just part of the anatomic feature, DICOM usually uses "structure" concepts that are more inclusive than the "entire" concepts.

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