> For the complete documentation index, see [llms.txt](https://docs.snomed.org/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://docs.snomed.org/implementation-guides/context-representation-implementation-guide/4-snomed-ct-and-context/4.2-context-representation-issues-in-snomed-ct.md).

# Procedure with Explicit Context

### Definition and Purpose <a href="#id-4.2procedurewithexplicitcontext-definitionandpurpose" id="id-4.2procedurewithexplicitcontext-definitionandpurpose"></a>

Procedures with explicit context describe situations where a medical procedure’s status, timing, or relationship to the patient is specified. These concepts clarify whether a procedure is planned, completed, or not done, among other statuses.

### Attributes Used <a href="#id-4.2procedurewithexplicitcontext-attributesused" id="id-4.2procedurewithexplicitcontext-attributesused"></a>

* **Associated Procedure**: Links the situation to the specific procedure being considered.
  * For example, |Lung transplant planned (situation)| uses this attribute to connect to |Lung transplant (procedure)|.
* **Procedure Context**: Describes the status of the procedure, such as whether it is planned, completed, or not done.
  * For example, |Lung transplant planned (situation)|, the procedure context is |Planned|.
* **Temporal Context**: Indicates when the procedure is or was to take place (past, present, future).
  * For example, |Lung transplant planned (situation)| uses |In the future| as the temporal context.
* **Subject Relationship Context**: Specifies who the procedure pertains to, usually the patient but can be a different person.
  * For example, |Mother’s surgery planned (situation)| would indicate the procedure pertains to the patient’s mother.

The default values for the context attributes for procedures assume that the procedure has occurred, is current or at a specified time, and pertains to the subject of the record.

### Associated Procedure <a href="#id-4.2procedurewithexplicitcontext-associatedprocedure" id="id-4.2procedurewithexplicitcontext-associatedprocedure"></a>

#### Awaiting transplantation of kidney <a href="#id-4.2procedurewithexplicitcontext-awaitingtransplantationofkidney" id="id-4.2procedurewithexplicitcontext-awaitingtransplantationofkidney"></a>

The SNOMED CT concept [698306007 |Awaiting transplantation of kidney (situation)|](http://snomed.info/id/698306007) describes a patient’s status as they await a kidney transplant. A key attribute here is [363589002 |Associated procedure (attribute)|](http://snomed.info/id/363589002) Associated procedure, which is [70536003 |Transplant of kidney (procedure)|](http://snomed.info/id/70536003) . This indicates that the focus of the situation is the upcoming kidney transplantation procedure. Additionally, the concept includes the [|Procedure context (attribute)|](http://snomed.info/id/408730004) as [|To be done (qualifier value)|](http://snomed.info/id/385643006) To be done, specifying that the transplant is planned but not yet performed, and it applies to the patient at the [|Current or specified time (qualifier value)|](http://snomed.info/id/410512000) .

<figure><img src="/files/ME63vcH0KuxR4FNx90B5" alt=""><figcaption></figcaption></figure>

### Examples - Procedure Context <a href="#id-4.2procedurewithexplicitcontext-examples-procedurecontext" id="id-4.2procedurewithexplicitcontext-examples-procedurecontext"></a>

#### Lung transplant planned (situation) <a href="#id-4.2procedurewithexplicitcontext-lungtransplantplanned-situation" id="id-4.2procedurewithexplicitcontext-lungtransplantplanned-situation"></a>

The SNOMED CT concept [704202004 |Lung transplant planned (situation)|](http://snomed.info/id/704202004) represents a planned lung transplant for a patient. A key attribute here is [|Procedure context (attribute)|](http://snomed.info/id/408730004)\
[397943006 |Planned (qualifier value)|](http://snomed.info/id/397943006) . This attribute indicates that the lung transplant is scheduled for the future and has not yet been performed. Additionally, the concept includes [|Associated procedure (attribute)|](http://snomed.info/id/363589002) as [|Transplant of lung (procedure)|](http://snomed.info/id/88039007)

, specifying the type of procedure planned. The [|Subject relationship context (attribute)|](http://snomed.info/id/408732007)

is [|Subject of record (person)|](http://snomed.info/id/410604004) , indicating that the procedure pertains to the patient themselves. The [|Temporal context (attribute)|](http://snomed.info/id/408731000) is [|Current or specified time (qualifier value)|](http://snomed.info/id/410512000) , showing that the procedure is relevant at the present time or based on a specific schedule.

<figure><img src="/files/m5t5H9ij0Wly34GC7944" alt=""><figcaption></figcaption></figure>

### Examples - Subject Relationship Context <a href="#id-4.2procedurewithexplicitcontext-examples-subjectrelationshipcontext" id="id-4.2procedurewithexplicitcontext-examples-subjectrelationshipcontext"></a>

#### Family history of mastectomy (situation) <a href="#id-4.2procedurewithexplicitcontext-familyhistoryofmastectomy-situation" id="id-4.2procedurewithexplicitcontext-familyhistoryofmastectomy-situation"></a>

The SNOMED CT concept [433977002 |Family history of mastectomy (situation)|](http://snomed.info/id/433977002) represents the occurrence of mastectomy within a patient’s family history. A key attribute here is Subject relationship context, which is [303071001 |Person in the family (person)|](http://snomed.info/id/303071001) . This attribute specifies that the mastectomy is related to a family member rather than the patient themselves. The concept also includes the associated procedure as [|Excision of breast (procedure)|](http://snomed.info/id/1231734007) , indicating that the mastectomy was the specific procedure performed, and the procedure context as Done, reflecting that the procedure has been completed. The temporal context is [|Current or past (actual) (qualifier value)|](http://snomed.info/id/410511007) , signifying that the procedure occurred in the past or is relevant at present.

<figure><img src="/files/GyuPT0OKw888VJ5T6Och" alt=""><figcaption></figcaption></figure>

### Examples - Temporal Context <a href="#id-4.2procedurewithexplicitcontext-examples-temporalcontext" id="id-4.2procedurewithexplicitcontext-examples-temporalcontext"></a>

The SNOMED CT concept [134651000119108 |History of estrogen therapy (situation)|](http://snomed.info/id/134651000119108) details a patient’s past use of estrogen hormone therapy. A key attribute here is [|Temporal context (attribute)|](http://snomed.info/id/408731000) , which is [410513005 |In the past (qualifier value)|](http://snomed.info/id/410513005) . This attribute specifies that the estrogen therapy occurred in the past. Additionally, the concept includes [|Associated procedure (attribute)|](http://snomed.info/id/363589002) as [|Estrogen hormone therapy (procedure)|](http://snomed.info/id/243125009) , indicating the specific therapy administered, and [|Procedure context (attribute)|](http://snomed.info/id/408730004) as [|Done (qualifier value)|](http://snomed.info/id/385658003) , showing that the therapy was completed. The subject relationship context is [|Subject relationship context (attribute)|](http://snomed.info/id/408732007) as [|Subject of record (person)|](http://snomed.info/id/410604004) , signifying that the therapy pertains to the patient themselves.

<figure><img src="/files/WTwfwRBWdrVFJhpKv4P4" alt=""><figcaption></figcaption></figure>

<a href="https://docs.google.com/forms/d/e/1FAIpQLScTmbZIf0UEQwYDkY27EEWBkaiYkHSbR0_9DmFrMLXoQLyL7Q/viewform?usp=pp_url&#x26;entry.1767247133=Context+Representation+Guide&#x26;entry.670899847=Procedure%20with%20Explicit%20Context" class="button primary">Provide Feedback</a>


---

# Agent Instructions
This documentation is published with GitBook. GitBook is the documentation platform designed so that both humans and AI agents can read, navigate, and reason over technical content effectively. Learn more at gitbook.com.

## Querying This Documentation
If you need additional information that is not directly available in this page, you can query the documentation dynamically by asking a question.

Perform an HTTP GET request on the current page URL with the `ask` query parameter, and the optional `goal` query parameter:

```
GET https://docs.snomed.org/implementation-guides/context-representation-implementation-guide/4-snomed-ct-and-context/4.2-context-representation-issues-in-snomed-ct.md?ask=<question>&goal=<endgoal>
```

`ask` is the immediate question: it should be specific, self-contained, and written in natural language.
`goal` is optional and describes the broader end goal you are ultimately trying to accomplish on behalf of the user. GitBook uses it to tailor the answer towards what is most useful for that goal.

The response will contain a direct answer to the question and relevant excerpts and sources from the documentation.

Use this mechanism when the answer is not explicitly present in the current page, you need clarification or additional context, or you want to retrieve related documentation sections.