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Medplum Terminology Services Update - 2026

· 5 min read
Matt Willer
Matt Willer
Founding Engineer, Medplum

We've been hard at work making updates to our Terminology Services to update them for 2026, and are excited to share all the new features and data sets available! The latest UMLS 2026AA data set has been imported into Medplum's hosted environment, and is available for customers to use in their self-hosted clusters as well. In addition, we've made a number of improvements across the core terminology API endpoints to make everything faster and serve multilingual users.

UMLS Release 2026AA​

The latest release of UMLS includes tens of thousands of new codes across the various code systems it covers, including many that may be clinically relevant for our users. Some of the highlights are shown below:

ICD-10-CM

CodeDescription
E11.AType 2 diabetes mellitus without complications, in remission
G35.A–DNew MS clinical-course subtypes: relapsing-remitting, primary/secondary progressive
Q89.81Kabuki syndrome
R11.16Cannabis hyperemesis syndrome
C50.A0–A2Malignant inflammatory neoplasm of breast (by laterality)
Z59.861Financial insecurity, difficulty paying for utilities (SDOH)

LOINC

CodeDescription
108097-7Monkeypox virus DNA [Presence] in Skin by NAA with probe detection
107547-2Comprehensive cardiomyopathy multigene analysis
107931-8Continuous glucose monitoring summary panel
112295-1Flu A/B + SARS-CoV-2 + RSV combo antigen panel (rapid)

RxNorm

DrugDescription
Yeztugo (lenacapavir)Twice-yearly injectable HIV PrEP
Blujepa (gepotidacin)First new oral antibiotic class for UTI in over 20 yrs
Enflonsia (clesrovimab)New RSV preventive monoclonal antibody for infants
RetatrutideInvestigational GIP/GLP-1/glucagon triple agonist (obesity/T2D)
Comirnaty/Spikevax/Fluzone 2025-2026Annual reformulated COVID/flu vaccines
Wyost, Jubbonti, Osenvelt, Conexxence, etc.New denosumab biosimilars to treat bone loss and osteoporosis
WidaplikNew triple-combination antihypertensive

SNOMED CT

CodeDescription
1366125001Monkeypox virus, subclade Ib
235978601000119107Current use of chimeric antigen receptor T-cell immunotherapy
1359763002Genetic syndromic childhood obesity
1356892008Arthritis caused by passive antibody therapy

New Scoped ValueSets​

To better serve clinical use cases, variants of the ValueSets for popular code systems are now available that are scoped to just the relevant codes a clinician might enter into a chart. For RxNorm, the Prescribable Subset tracks medications that can be prescribed in the United States; it is available as http://www.nlm.nih.gov/research/umls/rxnorm/vs/prescribable. In ICD10, the hierarchical nature of the code system means it includes many codes that strictly represent abstract categories, and which are not useful in actual charting. The subset of ICD10 entry terms is available as http://hl7.org/fhir/sid/icd-10-cm/vs/et, and should return more relevant codes.

SNOMED-to-ICD Map​

Medplum's ConceptMap/$translate endpoint has been completely overhauled to support more complex mappings, such as the SNOMED-to-ICD10 map. The full mapping is imported alongside the UMLS data above, and enables converting codes from one system to the other. For example, the SNOMED concept 10151000132103 (Viral fever) gives the following output:

{
  "resourceType": "Parameters",
  "parameter": [
    { "name": "result", "valueBoolean": true },
    {
      "name": "match",
      "part": [
        { "name": "equivalence", "valueCode": "equivalent" },
        {
          "name": "concept",
          "valueCoding": {
            "system": "http://hl7.org/fhir/sid/icd-10-cm",
            "code": "B34.9",
            "display": "Viral infection, unspecified"
          }
        },
        {
          "name": "property",
          "part": [
            { "name": "uri", "valueUri": "mapGroup" },
            { "name": "value", "valueInteger": 1 }
          ]
        },
        {
          "name": "property",
          "part": [
            { "name": "uri", "valueUri": "mapPriority" },
            { "name": "value", "valueInteger": 1 }
          ]
        }
      ]
    },
    {
      "name": "match",
      "part": [
        { "name": "equivalence", "valueCode": "equivalent" },
        {
          "name": "concept",
          "valueCoding": {
            "system": "http://hl7.org/fhir/sid/icd-10-cm",
            "code": "P81.9",
            "display": "Disturbance of temperature regulation of newborn, unspecified"
          }
        },
        {
          "name": "property",
          "part": [
            { "name": "uri", "valueUri": "mapGroup" },
            { "name": "value", "valueInteger": 2 }
          ]
        },
        {
          "name": "property",
          "part": [
            { "name": "uri", "valueUri": "mapPriority" },
            { "name": "value", "valueInteger": 1 }
          ]
        },
        {
          "name": "dependsOn",
          "part": [
            { "name": "attribute", "valueUri": "445518008" },
            {
              "name": "value",
              "valueQuantity": {
                "comparator": "<",
                "value": 29,
                "unit": "days"
              }
            }
          ]
        }
      ]
    },
    {
      "name": "match",
      "part": [
        { "name": "equivalence", "valueCode": "equivalent" },
        {
          "name": "concept",
          "valueCoding": {
            "system": "http://hl7.org/fhir/sid/icd-10-cm",
            "code": "R50.9",
            "display": "Fever, unspecified"
          }
        },
        {
          "name": "property",
          "part": [
            { "name": "uri", "valueUri": "mapGroup" },
            { "name": "value", "valueInteger": 2 }
          ]
        },
        {
          "name": "property",
          "part": [
            { "name": "uri", "valueUri": "mapPriority" },
            { "name": "value", "valueInteger": 2 }
          ]
        }
      ]
    }
  ]
}
Map Priority

The SNOMED-to-ICD map maintains a grouping and priority order that is critically important to how the mapping functions. The mappings should be evaluated in priority order by group, with all matched mappings collected to form the final mapped code set.

In the example above, SNOMED 10151000132103 maps to B34.9 and (P81.9 or R50.9); depending on the age of the patient, it will produce either B34.9 + P81.9 (for infants) or B34.9 + R50.9.

Support for translated display strings​

To better support customers and their patients who speak multiple languages, we've added full support for translated display strings on codes — called "designations" in FHIR. Search for codes in a specific language using the displayLanguage parameter in ValueSet/$expand:

curl 'https://api.medplum.com/fhir/R4/ValueSet/$expand?url=http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code&filter=fiev&displayLanguage=fr' \
  -H "Content-Type: application/fhir+json" \
  -H "Authorization: Bearer MY_ACCESS_TOKEN"

Database Improvements​

Behind the scenes, we've also made a number of performance tweaks to the database powering our terminology services to improve efficiency and speed up queries across the board.