Updating the extension to accommodate user requests for additions or changes is an important aspect of the overall extension maintenance process. Consumers of extensions need to be able to submit requests for changes, and the extension producer is responsible for providing a mechanism to collect and process these change requests. This process in turn supports the continued relevance and quality of the extension itself.

National Release Centers (NRCs) are responsible for collecting requests for changes detected by Affiliates. Organizations in Member countries or territories should therefore submit their content requests to the relevant NRC. The NRC will subsequently make a decision as to the relevance of the content for the International or National Edition, as described in 5.3 Assessing Requests

The type of service implemented to support change requests will depend on the scope and size of the extension, the anticipated number of extension consumers, and a range of other factors. In situations in which a small number of extension consumers are expected, a simple email service may be sufficient to enable consumers to request content changes. Extension producers with a greater number of anticipated consumers may decide to implement a dedicated system to support the tracking and management of change requests. SNOMED International has a formal procedure for submitting change requests, as described in the CRS User Guide.