diff --git a/custom/code_types.inc.php b/custom/code_types.inc.php
index 58744583b34..ee9e52fe661 100644
--- a/custom/code_types.inc.php
+++ b/custom/code_types.inc.php
@@ -325,16 +325,47 @@ function code_set_search($form_code_type,$search_term="",$count=false,$active=tr
     $res = sqlStatement($query,$sql_bind_array);
    }
   }
-  else if ($code_types[$form_code_type]['external'] == 2 || $code_types[$form_code_type]['external'] == 7) {
+  else if ($code_types[$form_code_type]['external'] == 2) {
    // Search from SNOMED (RF1) diagnosis codeset tables OR Search from SNOMED (RF1) clinical terms codeset tables
-   if ($code_types[$form_code_type]['external'] == 2) {
-     // Search from SNOMED (RF1) diagnosis codeset tables
-     $diagnosis_sql_specific = " ref.FullySpecifiedName LIKE '%(disorder)' ";
+   
+   // Search from SNOMED (RF1) diagnosis codeset tables
+   $diagnosis_sql_specific = " ref_conc.FullySpecifiedName LIKE '%(disorder)' ";
+   if ($active) {
+    // Only filter for active codes
+    // If there is no entry in codes sql table, then default to active
+    //  (this is reason for including NULL below)
+    $active_query=" AND (c.active = 1 || c.active IS NULL) ";
    }
-   else {
-     // Search from SNOMED (RF1) clinical terms codeset tables
-     $diagnosis_sql_specific = " 1=1 ";
+   // Ensure the sct_concepts sql table exists
+   $check_table = sqlQuery("SHOW TABLES LIKE 'sct_concepts'");
+   $check_table_2 = sqlQuery("SHOW TABLES LIKE 'sct_descriptions'");
+   if ( !(empty($check_table)) && !(empty($check_table_2)) ) {
+    $sql_bind_array = array();
+    $query = "SELECT ref_desc.ConceptId as code, ref_desc.Term as code_text, " .
+             "c.id, c.code_type, c.modifier, c.units, c.fee, " .
+             "c.superbill, c.related_code, c.taxrates, c.cyp_factor, c.active, c.reportable, c.financial_reporting, " .
+             "'" . add_escape_custom($form_code_type) . "' as code_type_name " .
+             "FROM `sct_concepts` as ref_conc " .
+             "LEFT OUTER JOIN `sct_descriptions` as ref_desc " .
+             "ON ref_conc.ConceptId = ref_desc.ConceptId AND ref_conc.ConceptStatus = 0 AND ref_desc.DescriptionStatus = 0 AND ref_desc.DescriptionType = 1 " .
+             "LEFT OUTER JOIN `codes` as c " .
+             "ON ref_desc.ConceptId = c.code AND c.code_type = ? ";
+    array_push($sql_bind_array,$code_types[$form_code_type]['id']);
+    if ($return_only_one) {
+     $query .= "WHERE (ref_desc.ConceptId = ? AND $diagnosis_sql_specific) $active_query $query_filter_elements ";
+     array_push($sql_bind_array,$search_term);
+    }
+    else {
+     $query .= "WHERE ((ref_desc.Term LIKE ? OR ref_desc.ConceptId LIKE ?) AND $diagnosis_sql_specific ) $active_query $query_filter_elements ";
+     array_push($sql_bind_array,"%".$search_term."%","%".$search_term."%");
+    }
+    $query .= "ORDER BY ref_desc.ConceptId $limit_query";
+    $res = sqlStatement($query,$sql_bind_array);
    }
+  }
+  else if ($code_types[$form_code_type]['external'] == 7) {
+   // Search from SNOMED (RF1) diagnosis codeset tables OR Search from SNOMED (RF1) clinical terms codeset tables
+   
    if ($active) {
     // Only filter for active codes
     // If there is no entry in codes sql table, then default to active
@@ -342,26 +373,26 @@ function code_set_search($form_code_type,$search_term="",$count=false,$active=tr
     $active_query=" AND (c.active = 1 || c.active IS NULL) ";
    }
    // Ensure the sct_concepts sql table exists
-   $check_table = sqlQuery("SHOW TABLES LIKE 'sct_concepts'");
+   $check_table = sqlQuery("SHOW TABLES LIKE 'sct_descriptions'");
    if ( !(empty($check_table)) ) {
     $sql_bind_array = array();
-    $query = "SELECT ref.ConceptId as code, ref.FullySpecifiedName as code_text, " .
+    $query = "SELECT ref.ConceptId as code, ref.Term as code_text, " .
              "c.id, c.code_type, c.modifier, c.units, c.fee, " .
              "c.superbill, c.related_code, c.taxrates, c.cyp_factor, c.active, c.reportable, c.financial_reporting, " .
              "'" . add_escape_custom($form_code_type) . "' as code_type_name " .
-             "FROM `sct_concepts` as ref " .
+             "FROM `sct_descriptions` as ref " .
              "LEFT OUTER JOIN `codes` as c " .
              "ON ref.ConceptId = c.code AND c.code_type = ? ";
     array_push($sql_bind_array,$code_types[$form_code_type]['id']);
     if ($return_only_one) {
-     $query .= "WHERE (ref.ConceptId = ? AND $diagnosis_sql_specific) $active_query $query_filter_elements ";
+     $query .= "WHERE ref.ConceptId = ? $active_query $query_filter_elements ";
      array_push($sql_bind_array,$search_term);
     }
     else {
-     $query .= "WHERE ((ref.FullySpecifiedName LIKE ? OR ref.ConceptId LIKE ?) AND $diagnosis_sql_specific ) $active_query $query_filter_elements ";
+     $query .= "WHERE (ref.Term LIKE ? OR ref.ConceptId LIKE ?) $active_query $query_filter_elements ";
      array_push($sql_bind_array,"%".$search_term."%","%".$search_term."%");
     }
-    $query .= "AND ref.ConceptStatus = 0 " .
+    $query .= "AND ref.DescriptionStatus = 0 AND ref.DescriptionType = 1 " .
               "ORDER BY ref.ConceptId $limit_query";
     $res = sqlStatement($query,$sql_bind_array);
    }
@@ -532,15 +563,15 @@ function lookup_code_descriptions($codes) {
       else if ($code_types[$codetype]['external'] == 2 || $code_types[$codetype]['external'] == 7) {
         // Collect from SNOMED (RF1) Diagnosis codeset tables OR Search from SNOMED (RF1) clinical terms codeset tables 
         // Ensure the sct_concepts sql table exists
-        $check_table = sqlQuery("SHOW TABLES LIKE 'sct_concepts'");
+        $check_table = sqlQuery("SHOW TABLES LIKE 'sct_descriptions'");
         if ( !(empty($check_table)) ) {
           if ( !(empty($code)) ) {
-            $sql = "SELECT `FullySpecifiedName` FROM `sct_concepts` " .
-                   "WHERE `ConceptId` = ? AND `ConceptStatus` = 0 LIMIT 1";
+            $sql = "SELECT `Term` FROM `sct_descriptions` " .
+                   "WHERE `ConceptId` = ? AND `DescriptionStatus` = 0 AND `DescriptionType` = 1 LIMIT 1";
             $crow = sqlQuery($sql, array($code) );
-            if (!empty($crow['FullySpecifiedName'])) {
+            if (!empty($crow['Term'])) {
               if ($code_text) $code_text .= '; ';
-              $code_text .= $crow['FullySpecifiedName'];
+              $code_text .= $crow['Term'];
             }
           }
         }
diff --git a/interface/code_systems/list_installed.php b/interface/code_systems/list_installed.php
index 11540e0a2b5..75f524f872b 100644
--- a/interface/code_systems/list_installed.php
+++ b/interface/code_systems/list_installed.php
@@ -44,8 +44,8 @@
 
 $db = isset($_GET['db']) ? $_GET['db'] : '0';
 
-// For now, only order by the revision_date. When have different formats of a code type (such as WHO vs CMS for ICD10 or different languages for SNOMED, then will incorporate this field)
-$rez = sqlStatement("SELECT DATE_FORMAT(`revision_date`,'%Y-%m-%d') as `revision_date`, `revision_version`, `name` FROM `standardized_tables_track` WHERE upper(`name`) = ? ORDER BY `revision_date` DESC", array($db) );
+// For now, only order by the imported_date. When have different formats of a code type (such as WHO vs CMS for ICD10 or different languages for SNOMED, then will incorporate this field)
+$rez = sqlStatement("SELECT DATE_FORMAT(`revision_date`,'%Y-%m-%d') as `revision_date`, `revision_version`, `name` FROM `standardized_tables_track` WHERE upper(`name`) = ? ORDER BY `imported_date` DESC", array($db) );
 for($iter=0; $row=sqlFetchArray($rez); $iter++) {
     $sqlReturn[$iter]=$row;
 }
diff --git a/interface/code_systems/list_staged.php b/interface/code_systems/list_staged.php
index 952d1c87e88..330149ed2ee 100644
--- a/interface/code_systems/list_staged.php
+++ b/interface/code_systems/list_staged.php
@@ -160,6 +160,28 @@
                     array_push($revisions,$temp_date);
                     $supported_file = 1;
                 }
+                else if (preg_match("/sct1_National_US_([0-9]{8}).zip/",$file,$matches)) {
+
+                    // This is the SNOMED US extension pack which can only be installed on top
+                    // of a International SNOMED version.
+                    // Hard code this version SNOMED feed to be US Extension
+                    //
+                    $version = "US Extension";
+                    $date_release = substr($matches[1],0,4)."-".substr($matches[1],4,-2)."-".substr($matches[1],6);
+                    $temp_date = array('date'=>$date_release, 'version'=>$version, 'path'=>$mainPATH."/".$matches[0]);
+                    array_push($revisions,$temp_date);
+                    $supported_file = 1;
+                }
+                else if (preg_match("/SnomedCT_Release-es_INT_([0-9]{8}).zip/",$file,$matches)) {
+
+                    // Hard code this SNOMED version feed to be International:Spanish
+                    //
+                    $version = "International:Spanish";
+                    $date_release = substr($matches[1],0,4)."-".substr($matches[1],4,-2)."-".substr($matches[1],6);
+                    $temp_date = array('date'=>$date_release, 'version'=>$version, 'path'=>$mainPATH."/".$matches[0]);
+                    array_push($revisions,$temp_date);
+                    $supported_file = 1;
+                }
                 else {
                     // nothing
                 }
@@ -289,28 +311,42 @@
   if ($success_flag === 1) {
     $action = "";
     if ($installed_flag === 1) {
-        if (strtotime($current_revision) == strtotime($file_revision_date)) {
-	    ?>
-	    <div class="error_msg"><?php echo xlt("The installed version and the staged files are the same."); ?></div>
-            <div class="stg msg"><?php echo xlt("Follow these instructions for installing or upgrading the following database") . ": " . text($db); ?><span class="msg" id="<?php echo attr($db); ?>_instrmsg">?</span></div>
-	    <?php
-        } else if (strtotime($current_revision) > strtotime($file_revision_date)) {
+        if ($current_name=="SNOMED" && $current_version!=$file_revision && $file_revision!="US Extension") {
+            // A new language of the SNOMED database has been staged, and will offer to Replace database with this staged version.
             ?>
-            <div class="error_msg"><?php echo xlt("The installed version is a more recent version than the staged files."); ?></div>
-            <div class="stg msg"><?php echo xlt("Follow these instructions for installing or upgrading the following database") . ": " . text($db); ?><span class="msg" id="<?php echo attr($db); ?>_instrmsg">?</span></div>
+            <div class="stg"><?php echo text(basename($file_revision_path)); ?> <?php echo xlt("is a different language version of the following database") . ": " . text($db); ?></div>
             <?php
-         } else if ($current_name=="SNOMED" && $current_version=="US Extension" && $file_revision=="US Extension") {
+            $action=xl("REPLACE");
+        } else if ($current_name=="SNOMED" && $current_version=="US Extension" && $file_revision=="US Extension") {
             // The Staged US Extension SNOMED package has already been installed
             ?>
             <div class="error_msg"><?php echo xlt("The compatible staged US Extension SNOMED package has already been installed."); ?></div>
             <div class="stg msg"><?php echo xlt("Follow these instructions for installing or upgrading the following database") . ": " . text($db); ?><span class="msg" id="<?php echo attr($db); ?>_instrmsg">?</span></div>
             <?php
-         } else if ( ($current_name=="SNOMED" && $file_revision=="US Extension") && (strtotime($current_revision." +4 month") < strtotime($file_revision_date)) ) {
+        } else if ($current_name=="SNOMED" && $current_version!="International:English" && $file_revision=="US Extension") {
+            // The Staged US Extension SNOMED file is not compatible with non-english snomed sets
+            ?>
+            <div class="error_msg"><?php echo xlt("The installed International SNOMED version is not compatible with the staged US Extension SNOMED package."); ?></div>
+            <div class="stg msg"><?php echo xlt("Follow these instructions for installing or upgrading the following database") . ": " . text($db); ?><span class="msg" id="<?php echo attr($db); ?>_instrmsg">?</span></div>
+            <?php
+        } else if ( ($current_name=="SNOMED" && $file_revision=="US Extension") && ((strtotime($current_revision." +6 month") < strtotime($file_revision_date)) || (strtotime($current_revision." -6 month") > strtotime($file_revision_date))) ) {
             // The Staged US Extension SNOMED file is not compatible with the current SNOMED International Package (ie. the International package is outdated)
             ?>
             <div class="error_msg"><?php echo xlt("The installed International SNOMED version is out of date and not compatible with the staged US Extension SNOMED file."); ?></div>
             <div class="stg msg"><?php echo xlt("Follow these instructions for installing or upgrading the following database") . ": " . text($db); ?><span class="msg" id="<?php echo attr($db); ?>_instrmsg">?</span></div>
             <?php
+        } else if ( (strtotime($current_revision) == strtotime($file_revision_date)) && !($current_name=="SNOMED" && $file_revision=="US Extension") ) {
+            // Note the exception here when installing US Extension
+	    ?>
+	    <div class="error_msg"><?php echo xlt("The installed version and the staged files are the same."); ?></div>
+            <div class="stg msg"><?php echo xlt("Follow these instructions for installing or upgrading the following database") . ": " . text($db); ?><span class="msg" id="<?php echo attr($db); ?>_instrmsg">?</span></div>
+	    <?php
+        } else if ( strtotime($current_revision) > strtotime($file_revision_date) && !($current_name=="SNOMED" && $file_revision=="US Extension") ) {
+            // Note the exception here when installing US Extension
+            ?>
+            <div class="error_msg"><?php echo xlt("The installed version is a more recent version than the staged files."); ?></div>
+            <div class="stg msg"><?php echo xlt("Follow these instructions for installing or upgrading the following database") . ": " . text($db); ?><span class="msg" id="<?php echo attr($db); ?>_instrmsg">?</span></div>
+            <?php
         } else {
 	    ?>
 	    <div class="stg"><?php echo text(basename($file_revision_path)); ?> <?php echo xlt("is a more recent version of the following database") . ": " . text($db); ?></div>
diff --git a/interface/code_systems/snomed_howto.php b/interface/code_systems/snomed_howto.php
index a633dee122a..9e0e365e0b4 100644
--- a/interface/code_systems/snomed_howto.php
+++ b/interface/code_systems/snomed_howto.php
@@ -41,6 +41,8 @@
 </li>
 </ol>
 <h5 class="error_msg"><?php echo xlt("NOTE: Only the Biannual International Snomed Release is currently supported"); ?></h5>
-<h5 class="error_msg"><?php echo "(" . xlt("Additionally, the corresponding US Snomed Extension Package can be imported separately after installing the International Snomed Release") . ")"; ?></h5>
+<h5 class="error_msg"><?php echo xlt("The following International Snomed Release languages are supported"); ?>: <?php echo xlt("English"); ?>, <?php echo xlt("Spanish"); ?></h5>
+<h5 class="error_msg"><?php echo "(" . xlt("Additionally, the corresponding US Snomed Extension Package can be imported separately after installing the International (English version) Snomed Release") . ")"; ?></h5>
+<h5 class="error_msg"><?php echo xlt("WARNING: If you are using the 2012-10-31 Spanish version, then note you need to unzip it once before placing it in the contrib/snomed (this is because the released file was \"double-zipped\")."); ?></h5>
 </p>
 </div>