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• active: Changing the concept's active attribute from active to inactive, or from inactive to active.
• definitionStatusId: Changing the concept's definition status from primitive to fully defined, or from fully defined to primitive.
• moduleId: Changing the concept's module. For example, this may occur when a concept is promoted. Please refer to 5.74.1.1 Moving Components Between ExtensionsPromotion and Demotion.

It should be noted that extensions should not modify the attributes of an international concept, unless this modification is necessary to meet legitimate clinical needs or to correct identified clinical issues. Any new version of an international concept that is created by an extension producer (other than SNOMED International) and which modifies the concept's mutable attributes, should be:

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