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Many clinical concepts are relevant in all countries, organizations and specialties but some concepts are relevant only to a particular environment. SNOMED CT is designed to allow the International Edition to be enhanced by adding Extensions to meet national or local requirements without compromising the main body of SNOMED CT. This is intended to meet the needs of different specialties and countries, regions, vendors and healthcare institutions.
Extensions are managed by IHTSDO Members or Affiliates who have been issued with a Namespace Identifier. A Namespace Identifier distinguishes the Identifiers of the Components created by an Organisationorganization. The responsibilities of organizations that create an Extension and provide it for use by other organizations include:

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• It has been supplied by the IHTSDO or another Organisation authorized organization authorized by the IHTSDO to provide such Extensions;
• The recognizing Organisation is organization is satisfied with the quality control procedures of the providing Organisationorganization.

The fact that an Organisation is organization is permitted to produce Extensions does not imply any a seal of approval related to of the quality of Extensions provided by that Organisationorganization produces. Therefore a person or Organisation that recognizes organization that authorizes or installs an Extension does so entirely at their own risk.

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