Every executable definition, side-panel definition and catalogue entry, in three groups by the licence of its
source, with its threshold in our own words and the source it is cited to. All are drafts pending review; a definition shows as reviewed only when both a clinical and a coding
approval are recorded. Default set library_default_set@1.1.
Local criteria: site choices among published definitions and named local
variants of the side-panel definitions, each with a change record, two approvals and an outcome preview.
Extended capabilities (licence required before commercial use)
These entries rest on sources that are not freely licensed: copyrighted guidelines and consensus statements, cited fact-only, and anything else that would need a licence or permission. They are kept here, apart from the core definitions, to show the product's full reach. Each threshold is restated in our own words with the source cited by title, body and year; no copyrighted text, table or figure is reproduced. Before commercial release each would be licensed from its publisher or re-sourced to a freely usable source.
11 executable, 1 side-panel, 14 catalogue.
Every entry here: licence or permission to be obtained before commercial use.
Setting: show extended capabilities on clinician screens
Current on clinician screens: Off (default)
When on, findings from extended definitions appear on the side panel and the per-note screen under their own heading, after the core
findings. Off or on, every check runs and replays the same, and the coder view shows both groups. The guided demo's four cases are unaffected.
Thresholds are stated in our own words. Verbatim text is kept only from U.S. government works and openly licensed (CC BY)
sources, with the attribution the licence asks for; copyrighted guidelines are cited by title, body and year, with a locator.
No endorsement by the cited bodies is implied. This is not legal advice: counsel should review before commercial release.
Cancer-treatment adverse-event grading scale (NCI CTCAE): off by default
CTCAE grades describe adverse events in people receiving cancer treatment, usually in trials; they are not diagnostic criteria, and several grades depend on the laboratory reference range or on clinical descriptors that are not encoded. Using them outside that setting is a local decision for the clinical reviewer.
Current: Off (default)
When on, grading entries are shown only as "another published definition gives …" or as values needing clinical judgement; they never
raise a "not stated" item.
CDI or coding staff can change this setting. A clinician account records clinical reviews; a coding or documentation account records coding reviews: switch the demo user.
11 of 26 in “Extended capabilities” shown · open an entry for its source, threshold and review.
ARDS oxygenation severity by PaO2/FiO2 (Berlin Definition 2012, numeric part only)berlin2012_ards_pf@1.01Cited source; wording is oursDraft · pending reviewdraft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
alternative beside oxygenation: Superseded by the 2024 global definition; shown only as an alternative beside global2024_ards_intubated_pf.
Edition
Berlin Definition 2012 (2012) (a newer edition exists)
Second source
American Thoracic Society-led global consensus (Am J Respir Crit Care Med 2024;209(1):37-47) 2024 · agrees: Same PaO2/FiO2 bands for intubated patients; the global definition adds SpO2/FiO2 alternatives and a non-intubated category.
Contested
no: The bands are shared by the 2024 global definition for intubated patients.
Acute respiratory distress syndrome: the Berlin Definition
berlin2012_ards_pf@1.0
In our words: Oxygenation bands (PaO2/FiO2, mm Hg): above 200 up to 300 mild; above 100 up to 200 moderate; 100 or less severe. The bands alone never establish the full syndrome.
ARDS Definition Task Force (European Society of Intensive Care Medicine initiative, endorsed by ATS and SCCM) (2012) · Abstract (Europe PMC record of PMID:22797452) · source
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
See also:
Acute respiratory distress syndrome: the Berlin definition — review, Critical Care (2013) · link — open-licence restatement (CC BY per Europe PMC metadata only; not verified)
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Hypertension
Tier
1
Licence
Cited source; wording is ours
Commercial use
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
alternative beside blood_pressure: Disagrees with the primary (nhlbi_bp_categories: 130/80 vs 140/90); shown only as 'another published definition gives'.
Edition
2024 (2024)
Second source
National Heart, Lung, and Blood Institute 2025 · disagrees: US categories start hypertension at 130/80; ESC at 140/90. The ESH 2023 guideline could not be opened (HTTP 402).
Contested
yes: Differs from AHA/ACC (hypertension from 130/80; elevated defined by systolic 120-129 only).
2024 ESC Guidelines for the management of elevated blood pressure and hypertension
esc2024_office_bp@1.0
In our words: Office blood pressure (adults, mm Hg): 140/90 or higher is hypertension; systolic 120 to 139 or diastolic 70 to 89 is elevated; below 120/70 is not elevated.
European Society of Cardiology (2024) · Section 5.1, Table 5 (office BP) · source
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
See also:
High Blood Pressure: Diagnosis, National Heart, Lung, and Blood Institute (2025) · link — federal primary for blood pressure in this product (nhlbi_bp_categories); differs at 130/80
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.
Clinical review: none recorded yet.
Coding review: none recorded yet.
Hyponatraemia, presence only (ESE/ESICM/ERA-EDTA 2014)ese2014_hyponatraemia@1.01Cited source; wording is oursDraft · pending reviewdraft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Hyponatraemia
Tier
1
Licence
Cited source; wording is ours
Commercial use
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
default set (sodium)
Edition
2014 (2014) (currency not confirmed)
Second source
National Cancer Institute, Cancer Therapy Evaluation Program (U.S. Department of Health and Human Services) 2025 · partly agrees: CTCAE starts at the laboratory LLN, which is often but not always 135 mmol/L.
Contested
no: The <135 mmol/L definition is widely shared; CTCAE uses the laboratory LLN instead.
Clinical practice guideline on diagnosis and treatment of hyponatraemia
ese2014_hyponatraemia@1.0
In our words: Serum sodium below 135 mmol/L is low.
European Society of Intensive Care Medicine, European Society of Endocrinology and European Renal Association – European Dialysis and Transplant Association (ERBP) (2014) · Abstract · source
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
See also:
Laboratory reference interval, the reporting laboratory — no federal or openly licensed source for 135 mmol/L was opened; the laboratory's own range is the recommended alternative
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.
Clinical review: none recorded yet.
Coding review: none recorded yet.
ARDS oxygenation severity in intubated patients by PaO2/FiO2 with PEEP ≥5 (New Global Definition 2024, numeric part only)global2024_ards_intubated_pf@1.01Cited source; wording is oursDraft · pending reviewdraft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
default set (oxygenation)
Edition
New Global Definition 2024 (2024)
Second source
ARDS Definition Task Force 2012 · agrees: Same bands (the Berlin abstract does not state the PEEP requirement).
Contested
no: Bands unchanged from Berlin for intubated patients.
A New Global Definition of Acute Respiratory Distress Syndrome
global2024_ards_intubated_pf@1.0
In our words: On invasive ventilation with PEEP of at least 5 cm H2O (PaO2:FiO2, mm Hg): above 200 up to 300 mild; above 100 up to 200 moderate; 100 or less severe.
American Thoracic Society-led global consensus (Am J Respir Crit Care Med 2024;209(1):37-47) (2024) · Table 1 'Diagnostic Criteria for the New Global Definition of ARDS', intubated ARDS and footnote ¶ · source
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
See also:
Acute respiratory distress syndrome: the Berlin definition, ARDS Definition Task Force (2012) — same bands
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.
Clinical review: none recorded yet.
Coding review: none recorded yet.
COPD airflow obstruction grade by post-bronchodilator spirometry (GOLD 2026)gold2026_copd_airflow@1.01Cited source; wording is oursDraft · pending reviewdraft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
default set (copd_airflow)
Edition
2026 report (2026)
Second source
none opened · not found: No independent second source (e.g. ATS/ERS) was opened.
Contested
yes: The fixed ratio 0.7 is contested against the lower limit of normal (z-score) approach used by ATS/ERS interpretation standards (not opened); the fixed ratio over-diagnoses in older and under-diagnoses in younger adults.
Global Strategy for Prevention, Diagnosis and Management of COPD: 2026 Report — Pocket Guide
gold2026_copd_airflow@1.0
In our words: When FEV1/FVC after a bronchodilator is below 0.7: FEV1 80% of predicted or more is grade 1; 50 to under 80% grade 2; 30 to under 50% grade 3; under 30% grade 4. A ratio of 0.7 or more shows no obstruction by this fixed ratio.
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
See also:
VA/DoD Clinical Practice Guideline for the Management of COPD, VA and DoD (2026) · link — federal; recommends post-bronchodilator spirometry but its summary gives no numeric ratio
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.
Clinical review: none recorded yet.
Coding review: none recorded yet.
Serum 25(OH)D reference levels for bone health (Institute of Medicine 2011)iom2011_vitamin_d@1.01Cited source; wording is oursDraft · pending reviewdraft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Vitamin D status
Tier
1
Licence
Cited source; wording is ours
Commercial use
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
not run by default: The source explicitly declined to define deficiency; not run by default.
Edition
2011 dietary reference intakes (2011) (currency not confirmed)
Second source
Endocrine Society 2011 · partly agrees: Both use 20 ng/mL (50 nmol/L) as a boundary; the Endocrine Society calls 21-29 ng/mL insufficient, which the IOM does not.
Contested
yes: See es2011_vitamin_d: bodies disagree; the IOM explicitly declined to set a deficiency cut-point.
The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know
iom2011_vitamin_d@1.0
In our words: Serum 25(OH)D: below 16 ng/mL (40 nmol/L) is under the level that meets about half the population's needs; 16 to under 20 ng/mL is under the level that meets nearly everyone's needs; 20 to 50 ng/mL meets nearly everyone's needs; above 50 ng/mL (125 nmol/L) may carry a risk of harm.
Institute of Medicine committee (J Clin Endocrinol Metab 2011;96:53-58, doi:10.1210/jc.2010-2704) (2011) · Section 'Serum 25OHD Levels and Screening' · source
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
See also:
Vitamin D fact sheet for health professionals, NIH Office of Dietary Supplements · link — federal restatement; not verified (HTTP 403 on 2026-11-14)
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.
Clinical review: none recorded yet.
Coding review: none recorded yet.
Serum lactate above the Sepsis-3 septic-shock threshold (numeric component only)sepsis3_septic_shock_lactate@1.01Cited source; wording is oursDraft · pending reviewdraft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Septic shock (lactate component)
Tier
1
Licence
Cited source; wording is ours
Commercial use
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
default set (lactate)
Edition
Sepsis-3 (2016) (2016)
Second source
none opened · not found: No independent second source was opened for this threshold.
Contested
no: The CMS SEP-1 measure and the Surviving Sepsis Campaign use lactate thresholds for other purposes (for example ≥4 mmol/L); those documents were not opened for this entry.
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
sepsis3_septic_shock_lactate@1.0
In our words: A lactate above 2 mmol/L (18 mg/dL) is the lactate part of the septic-shock criteria; it never establishes septic shock on its own.
Society of Critical Care Medicine and European Society of Intensive Care Medicine task force (JAMA 2016;315:801-810) (2016) · Box 3 'New Terms and Definitions' · source
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
See also:
Hospital Toolkit for Adult Sepsis Surveillance, Centers for Disease Control and Prevention (2018), Adult Sepsis Event, optional lactate criterion · link — federal, surveillance only: lactate 2.0 mmol/L or more (not above 2); not merged with this entry; opened by the resourcing review, not re-opened in this build
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.
Clinical review: none recorded yet.
Coding review: none recorded yet.
Hyperkalaemia and its severity (UK Kidney Association, July 2026 update)ukka2026_hyperkalaemia@1.01Cited source; wording is oursDraft · pending reviewdraft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Hyperkalaemia
Tier
1
Licence
Cited source; wording is ours
Commercial use
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
default set (potassium)
Edition
updated July 2026 (2026)
Second source
National Cancer Institute, Cancer Therapy Evaluation Program (U.S. Department of Health and Human Services) 2025 · disagrees: CTCAE uses different bands; the UKKA text states its 5.5 mmol/L threshold comes from the European Resuscitation Council guideline, which was not opened.
Contested
yes: The guideline itself says that no definition of hyperkalaemia is universally accepted; it adopts the ERC threshold of 5.5 mmol/L. CTCAE grades differ (see ctcae6_hyperkalaemia).
Clinical Practice Guidelines: Treatment of Acute Hyperkalaemia in Adults
ukka2026_hyperkalaemia@1.0
In our words: Serum potassium (adults): 5.5 to 5.9 mmol/L mild; 6.0 to 6.4 moderate; 6.5 or higher severe.
UK Kidney Association (2026) · Introduction, document page 9 (PDF page 10) · source
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
See also:
Laboratory reference interval, the reporting laboratory — no federal potassium definition was opened; the laboratory's own range is the recommended alternative
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.
Clinical review: none recorded yet.
Coding review: none recorded yet.
Osteoporosis and osteopenia by BMD T-score (WHO 1994)who1994_osteoporosis@1.01Cited source; wording is oursDraft · pending reviewdraft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Osteoporosis / osteopenia
Tier
1
Licence
Cited source; wording is ours
Commercial use
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
default set (bone_density)
Edition
WHO Technical Report Series 843 (1994) (1994) (currency not confirmed)
Second source
none opened · not found: ISCD official positions and national guidelines that restate the categories were not opened.
Contested
yes: T-score categories were defined for postmenopausal (white) women; their use in men and other populations relies on later bodies (e.g. ISCD), which were not opened; the report itself calls cut-off values 'somewhat arbitrary'.
Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO Study Group (WHO Technical Report Series 843)
who1994_osteoporosis@1.0
In our words: Bone density T-score (postmenopausal women): -1 or higher normal; between -1 and -2.5 low bone mass; -2.5 or lower osteoporosis; below -2.5 with a fragility fracture severe osteoporosis.
World Health Organization (1994) · Section 2.1 Definitions, printed pages 5-6 (PDF pages 11-12) · source
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
See also:
NIH restatement of the T-score categories, National Institutes of Health — not verified (pages returned 403 or did not resolve)
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.
Clinical review: none recorded yet.
Coding review: none recorded yet.
Iron deficiency by serum ferritin (WHO 2020)who2020_iron_deficiency_ferritin@1.01Cited source; wording is oursDraft · pending reviewdraft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Iron deficiency
Tier
1
Licence
Cited source; wording is ours
Commercial use
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
default set (ferritin)
Edition
2020 (2020)
Second source
none opened · not found: No independent source with the same cut-offs was opened.
Contested
yes: Ferritin cut-offs for iron deficiency vary widely between bodies and studies (the guideline's own review cites thresholds from <12 to <30 µg/L in pregnancy); WHO's are low (high specificity). Other bodies (e.g. gastroenterology guidance) use higher values; those texts were not opened.
WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations
who2020_iron_deficiency_ferritin@1.0
In our words: Ferritin suggesting iron deficiency: below 15 µg/L at 5 years and older (healthy) and in first-trimester pregnancy; below 12 µg/L under 5 years (healthy); below 30 µg/L under 5 with infection or inflammation; below 70 µg/L at 5 and older with infection or inflammation.
World Health Organization (2020) · Executive summary, recommendations 1.1-1.2 (PDF page 11) and Table 1 (PDF page 12) · source
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.
Clinical review: none recorded yet.
Coding review: none recorded yet.
Anaemia and its severity by haemoglobin (WHO 2024)who2024_anaemia@1.01Cited source; wording is oursDraft · pending reviewdraft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Anaemia
Tier
1
Licence
Cited source; wording is ours
Commercial use
Licence or permission to be obtained before commercial use. Thresholds restated in our own words; source cited; no text reproduced.
Source checked
opened on 2026-11-14: Opened by the build that encoded this entry; the threshold matches the opened text.
Use here
default set (haemoglobin)
Edition
2024 (2024)
Second source
National Cancer Institute, Cancer Therapy Evaluation Program (U.S. Department of Health and Human Services) 2025 · partly agrees: CTCAE v6.0 also uses 80 g/L as a severity boundary (grade 3 <80 g/L, WHO severe <80 g/L for adults) but defines the start of anaemia by the laboratory LLN, not fixed WHO cut-offs. No independent source repeating the WHO 2024 table was opened.
Contested
yes: Cut-offs are 5th percentiles of mostly higher-income populations (WHO's own remark); the men's 130 g/L cut-off and severity percentages were debated by the guideline group; CTCAE and laboratory reference ranges use other limits; older adults (>65) are not covered.
Guideline on haemoglobin cutoffs to define anaemia in individuals and populations
who2024_anaemia@1.0
In our words: Haemoglobin, adults 15 to 65, adjusted for altitude and smoking: anaemia below 130 g/L in men and below 120 g/L in non-pregnant women; moderate below 110 g/L; severe below 80 g/L. Pregnancy by trimester and children have their own cut-offs.
cited source; wording is ours (numbers restated, no text reproduced). No endorsement by the cited bodies is implied.
See also:
Anemia: Diagnosis, National Heart, Lung, and Blood Institute (2025) — federal page gives normal ranges only (men 14 to 17 g/dL, women 12 to 15 g/dL), not anaemia cut-offs
Laboratory reference interval, the reporting laboratory — shown beside the WHO cut-offs where the laboratory sends one
Review
Reviewed only when both a clinical review and a coding review are recorded as approved.