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The abstract ExtensibleTerminologyTerm class acts as a template that defines 2 attributes, either (but not both) of which may be used be used to indicate the value used for an attribute associated assigned to an attribute associated with an extensible enumeration. The controlledTerm attribute is used to specify one 1 of the permissible values from the enumeration or the sponsorTermId attribute is used to indicate which sponsor term is used in the terminology extension for the enumeration. 

There are 8 specializations of the ExtensibleTerminologyTerm class: There is a pair of specializations for each of the 4 extensible enumerations, with 1 of the pair specifying use of only the controlledTerm attribute and the other specifying use of only the sponsorTermId attribute.

These specializations are designed to constrain the use of attributes and enumerations for attributes associated with extensible enumerations. In practice, sponsors simply populate any attribute associated with an extensible enumeration with either:

• A controlledTerm attribute containing one of the permissible values from the associated enumeration, or
• A sponsorTermId attribute containing the identifier of a sponsor term defined in the terminology extension for the associated enumeration.