I'm using HealthcareService.specialty to represent various special care needs. I'm wondering if I can use the SNOMED qualifier value "90845004 Heavy (weight)" for one of them. Specifically, I'm unsure about how to represent "Overweight 120+ Kg" in this context. (It's not an observation). For context, other specialties include: Adult mental illness, Critical care medicine, Psychiatry.
I look into snomed and found all the accepted values are qualifier values. Then I searched for something related to weight which is also a qualifier value and found "90845004 Heavy (weight)"
Betty, the basic answer is that the 90845004 SNOMED CT code |Heavy (weight) (qualifier value)| isn't a very appropriate choice of code to use for the HealthcareService.specialty element, as the definition of the element states that it is a "Collection of specialties handled by the Healthcare service." The 90845004 |Heavy (weight) (qualifier value)| code is positioned in the SNOMED CT hierarchy under Qualifier value/Descriptor/Dimensions/Weights, which is very different from a clinical specialty. To be clear, this code would still be allowed to be used, as the element binding to the Practice Setting Code Value Set (c80-practice-codes) is preferred (not required or extensible). So it wouldn't technically be an error to use the "Heavy" code, but it would not be a sensible thing to do given the definition of the resource element.
The definition of the c80-practice-codes value set appears to select SNOMED CT codes that are under 394658006 |Clinical specialty (qualifier value)| (I didn't actually check each one, but that seems to be the pattern), which makes sense. So that is the first place that I would look in SNOMED CT to find other codes that would be appropriate for the meaning that you are wanting to express. My guess is that by choosing the "Heavy" code you are probably thinking of a specialty like "weight management" or "obesity" or "bariatric medicine", or something similar to that. So we can look for a SNOMED CT code for one of those, or whatever else may be related. But in the International Edition of SNOMED CT I am actually not finding anything under "Clinical specialty" like that. The closest that I found are 50681000087109 |Bariatric surgeon (occupation)|, which is in a different SNOMED CT hierarchy, and 2391000175104 |Bariatric surgery service (qualifier value)|, which is in Qualifier value, but under "Services, facilities and utilities" rather than under "Clinical specialty". So, you could choose to use the "services" code if that seems to be close enough. Or you could make a request for a new SNOMED CT code to be added (probably through the NLM for the US extension initially) for "Bariatric medicine" (or similar). That's how I would go about approaching this, I believe.