Health Evidence Review Commission's Value-based Benefits Subcommittee

Line merging – fewer line merges proposal
1) Merge line 15 CONGENITAL INFECTIOUS DISEASES and 16 CONGENITAL SYPHILIS
a. Same score, syphilis is an infectious disease
2) Merge line 17 VERY LOW BIRTH WEIGHT (UNDER 1500 GRAMS) and line 23 LOW BIRTH
WEIGHT (1500-2500 GRAMS)
a. Similar scoring, mostly overlapping diagnosis codes
3) Merge line 21 SYNDROME OF "INFANT OF A DIABETIC MOTHER" AND NEONATAL
HYPOGLYCEMIA, 35 NEONATAL THYROTOXICOSIS, and line 45 HYPOCALCEMIA,
HYPOMAGNESEMIA AND OTHER ENDOCRINE AND METABOLIC DISTURBANCES SPECIFIC
TO THE FETUS AND NEWBORN
a. All are endocrine issues for neonates
b. Scoring varies between 3000 and 4000
4) Merge lines 36 HEMATOLOGICAL DISORDERS OF FETUS AND NEBORN, 77 POLYCYTHEMIA
NEONATORUM, SYMPTOMATIC, 149 ANEMIA OF PREMATURITY OR TRANSIENT
NEONATAL NEUTROPENIA
a. All are hematologic issues for neonates
b. Scoring varies between 2000 and 3200
5) Merge lines 27 INTRACRANIAL HEMORRHAGES; CEREBRAL CONVULSIONS, DEPRESSION,
COMA, AND OTHER ABNORMAL CERERAL SIGNS OF THE NEWBORN and 34 SEVERE
BIRTH TRAUMA FOR BABY
a. Line 34 contains nearly all diagnosis codes for intracranial hemorrhages. Other
diagnoses include other CNS injuries
b. Scoring is nearly identical