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Generally, |Severity (attribute)| is not used to model concepts precoordinated in the International Release, but there are some exceptions. 

Non-standardized or locally defined severity values will not be recognized or supported in SNOMED CT.  However, severity values explicitly defined and standardized by an internationally recognized standard are acceptable.  A valid exception requires an internationally accepted definition that can be consistently applied and used reliably for international comparison.  Even though a reference may be internationally sourced, its use may not always be uniformly applied by multiple countries. Classifications of severity that represent variation in clinical presentations and enact limitations with age ranges, sex, or pregnancy status, do not apply universally to all patients of all ages, prove problematic, and may not be generally useful. 

The requestor is responsible for obtaining permission for use in SNOMED CT if required by the international body.  

As an alternative to precoordination pre-coordination in the international release, this severity attribute can be used as a qualifier in postcoordinationin postcoordination.  However, beware that that postcoordination of severity results in the same irreproducibility issues as pre-coordination.