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  2. CQM-7006

CMS 646 looks for any tumor staging

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      Thank you for your question regarding CMS646v4 (Intravesical Bacillus-Calmette-Guerin for non-muscle invasive bladder cancer).

      You are correct regarding the ‘First Bladder Cancer Staging Procedure’ definition. The measure first looks for tumor staging using SNOMEDCT code 254292007 (“Tumor staging (tumor staging)”) which is not specific to bladder cancer tumor staging. Then, the ‘Most Recent Bladder Cancer Tumor Staging is Ta HG, Tis, T1’ definition looks specifically for SNOMEDCT codes specific to bladder cancer tumor staging.

      Has Most Recent Bladder Cancer Tumor Staging is Ta HG, Tis, T1

      ( "First Qualifying Bladder Cancer Staging Procedure" FirstBladderCancerStagingMP
          where FirstBladderCancerStagingMP.result ~ "T1: Urinary tract tumor invades subepithelial connective tissue (finding)"
            or FirstBladderCancerStagingMP.result ~ "Ta: Noninvasive papillary carcinoma (urinary tract) (finding)"
            or FirstBladderCancerStagingMP.result ~ "Tis: Carcinoma in situ (flat tumor of urinary bladder) (finding)"
            or FirstBladderCancerStagingMP.result ~ "Carcinoma in situ of bladder"
      ) is not null

      We will consider making an update during the next Annual Update cycle.
      Show
      Thank you for your question regarding CMS646v4 (Intravesical Bacillus-Calmette-Guerin for non-muscle invasive bladder cancer). You are correct regarding the ‘First Bladder Cancer Staging Procedure’ definition. The measure first looks for tumor staging using SNOMEDCT code 254292007 (“Tumor staging (tumor staging)”) which is not specific to bladder cancer tumor staging. Then, the ‘Most Recent Bladder Cancer Tumor Staging is Ta HG, Tis, T1’ definition looks specifically for SNOMEDCT codes specific to bladder cancer tumor staging. Has Most Recent Bladder Cancer Tumor Staging is Ta HG, Tis, T1 ( "First Qualifying Bladder Cancer Staging Procedure" FirstBladderCancerStagingMP     where FirstBladderCancerStagingMP.result ~ "T1: Urinary tract tumor invades subepithelial connective tissue (finding)"       or FirstBladderCancerStagingMP.result ~ "Ta: Noninvasive papillary carcinoma (urinary tract) (finding)"       or FirstBladderCancerStagingMP.result ~ "Tis: Carcinoma in situ (flat tumor of urinary bladder) (finding)"       or FirstBladderCancerStagingMP.result ~ "Carcinoma in situ of bladder" ) is not null We will consider making an update during the next Annual Update cycle.
    • CMS0646v4

      First Bladder Cancer Staging Procedure

      • First(["Procedure, Performed": "Tumor staging (tumor staging)"] BladderCancerStaging
        with "Bladder Cancer Diagnosis" BladderCancer
        such that Global."NormalizeInterval"(BladderCancerStaging.relevantDatetime, BladderCancerStaging.relevantPeriod) starts on or before day of start BladderCancer.prevalencePeriod
        sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)
        )

       

      CMS 646 looks for any cancer staging, not necessarily one for bladder cancer. This is similar to how CMS 129 was, but it was fixed in 2025:

      Most Recent Prostate Cancer Staging T1a to T2a

      • ( Last((["Procedure, Performed": "Tumor staging (tumor staging)"] ProstateCaStaging
        where exists("Prostate Cancer Diagnosis" ProstateCaDx
        where ProstateCaDx.id in ProstateCaStaging.relatedTo
        )) ProstateCancerStaging
        with "First Prostate Cancer Treatment during day of Measurement Period" FirstProstateCancerTreatment
        such that Global."NormalizeInterval"(ProstateCancerStaging.relevantDatetime, ProstateCancerStaging.relevantPeriod) starts before start of Global."NormalizeInterval"(FirstProstateCancerTreatment.relevantDatetime, FirstProstateCancerTreatment.relevantPeriod)
        sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)
        ) ) LastProstateCancerStaging
        where ( LastProstateCancerStaging.result ~ "American Joint Committee on Cancer cT1a (qualifier value)"
        or LastProstateCancerStaging.result ~ "American Joint Committee on Cancer cT1b (qualifier value)"
        or LastProstateCancerStaging.result ~ "American Joint Committee on Cancer cT1c (qualifier value)"
        or LastProstateCancerStaging.result ~ "American Joint Committee on Cancer cT2a (qualifier value)"
        )

            edave Mathematica EC eCQM Team
            GeorgeWu George Wu
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