Brief Description of Measure:
​CMS646: Intravesical Bacillus-Calmette-Guerin for non-muscle invasive bladder cancer:
Percentage of patients initially diagnosed with non-muscle invasive bladder cancer and who received intravesical Bacillus-Calmette-Guerin (BCG) within 6 months of bladder cancer staging.

Description of Issue:
​During the last annual update, the 'Normalize Interval' function was added to a number of logic definitions across eCQMs to account for when information stored can either look for a point in time or an interval. The measure developer has identified a definition that would benefit from adding this function to the Most Recent Bladder Cancer Staging Procedure, which currently uses the relevantPeriod attribute.

Proposed Solution:
CURRENT LOGIC:​
HIV Diagnosis
exists ["Diagnosis": "HIV"] HIV
  with "Most Recent Bladder Cancer Staging Procedure" Staging
    such that HIV.prevalencePeriod starts on or before start of Staging.relevantPeriod
 
PROPOSED LOGIC:
HIV Diagnosis
exists ["Diagnosis": "HIV"] HIV
  with "Most Recent Bladder Cancer Staging Procedure" Staging
    such that HIV.prevalencePeriod starts on or before start of Global."NormalizeInterval" ( Staging.relevantDatetime, Staging.relevantPeriod )

Rationale for Change:
​This change meets the current standard and  will allow for greater flexibility in implementation to look for either a single point in time or an interval.