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Health Care Practice Recommendations 

 

Preventive Health 

BlueCross BlueShield of Tennessee values the care our providers deliver to our members every day. For your convenience, we’ve provided a link to a helpful guide published by the U.S. Preventive Services Task Force below.

Clinical Practice Guidelines

BlueCross adopts and disseminates specific nationally recognized clinical practice guidelines for use by our network providers. The guidelines address acute and chronic medical services, and behavioral health services to assist Practitioners in making appropriate health care decisions for specific clinical circumstances. It’s our intent to make resources available to our providers that will help in this endeavor. BlueCross attests that the text and format of these compendia have not been altered in any way, and that these resources should not be construed as a legal or required standard of care.

BCBST has created a direct link from our website to these guidelines. We hope this will be both convenient and helpful to you in caring for your patients. Paper copies of the guidelines are available upon request by calling (423) 535-6705.

Behavior Health CPGs


Autism (Pediatric)

2014 American Academy of Child & Adolescent Psychiatry (AACAP) Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder

(Last reviewed 2/2018)

http://www.aacap.org/aacap/Resources_for_Primary_Care/Practice_Parameters_and_Resource_Centers/Practice_Parameters.aspx

Depression 

2016 Veteran’s Affairs/Department of Defense (VADoD) Clinical Practice Guideline for the Management of Major Depressive Disorder 

(Last reviewed 2/2018)

https://www.healthquality.va.gov/guidelines/MH/mdd/

Substance Abuse 

2015  Substance Abuse and Mental Health Services Administration (SAMHSA) A Treatment Improvement Protocol: Substance Abuse Treatment and Family Therapy

(Last reviewed 2/2018)

https://www.ncbi.nlm.nih.gov/books/NBK64265/


Medical CPGs


Asthma 

2007 National Heart, Lung, and Blood Institute (NIH) EPR-3 Guidelines for the Diagnosis and Management of Asthma (includes: 2008 edits to the 2007 guideline)

(Last reviewed 3/2017)

https://www.nhlbi.nih.gov/health-topics/guidelines-for-diagnosis-management-of-asthma

Back Pain 

2017 American College of Physicians (ACP) Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline

(Last reviewed 7/2017)

http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice

Bright Futures ™ (Pediatrics) 

2017 Bright Futures™ Guidelines for Prevention and Health Promotion for Infants, Children, Adolescents, and their Families – Forth Edition (The 2017 Bright Futures/American Academy of Pediatrics Periodicity Schedule Recommendations is under the ‘Materials & Tools’ tab at the top of the page)

(Last reviewed 7/2017)

http://brightfutures.aap.org/3rd_Edition_Guidelines_and_Pocket_Guide.html

COPD 

2018 Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease Global Obstructive Lung Disease (GOLD); Report

(Last reviewed 3/2017)

http://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf

Cholesterol 

2013 American College of Cardiology Foundation (ACCF)/American Heart Association (AHA); Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults

(Last reviewed 3/2017)

http://circ.ahajournals.org/content/129/25_suppl_2/S1.full.pdf+html

Coronary Risk Reduction 

2011 American Heart Association and American College of Cardiology Foundation (AHA/ACCF) Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease

(Last reviewed 3/2017)

http://circ.ahajournals.org/content/124/22/2458

Diabetes 

2018 American Diabetes Association; Standards of Medical Care in Diabetes

(Last reviewed 3/2017)

https://professional.diabetes.org/content-page/standards-medical-care-diabetes

Headache 

2012 American Academy of Neurology (AAN) and the American Headache Society (AHS) Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee

(Last reviewed 3/2017)

http://www.neurology.org/content/78/17/1337.full.pdf+html?sid=1bc82d50-bf16-4f1f-b950-7a9a433b18d7


2013 Corrections  http://www.neurology.org/content/80/9/871.full.pdf+html

Heart Failure 

2013 American College of Cardiology Foundation/American Heart Association; Guideline for the Management of Heart Failure:  A Report of the ACCF/AHA Task Force on Practice Guidelines

(Last reviewed 7/2017)

http://circ.ahajournals.org/content/early/2013/06/03/CIR.0b013e31829e8776.full.pdf

HTN 

2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)

(Last reviewed 7/2017)

http://www.measureuppressuredown.com/HCProf/Find/BPs/JNC8/specialCommunication.pdf

Immunizations 

2018 Center for Disease Control & Prevention; Recommended Immunization Schedules: For Healthcare Professionals: Child, Adolescent & Catch-up

(Last reviewed 3/2017)

https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html

Obesity 

2013 National Institute of Health; Managing Overweight and Obesity in Adults: Systematic Evidence Review from the Obesity Expert Panel

(Last reviewed 3/2017)

https://www.nhlbi.nih.gov/health-topics/managing-overweight-obesity-in-adults

Prenatal 

2018 American Congress of Obstetricians and Gynecologists; Guidelines for Perinatal Care, Eighth Edition. Available for Purchase at

(Last reviewed 3/2017)

 

http://sales.acog.org/Guidelines-for-Perinatal-Care-Seventh-Edition-P262C54.aspx

Non ST-Elevated MI 

2014 American College of Cardiology Foundation/American Heart Association (ACCF/AHA) Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes

(Last reviewed 7/2017)

 

https://circ.ahajournals.org/content/130/25/e344.full

ST-Elevated MI 

2013 American College of Cardiology Foundation/American Heart Association (ACCF/AHA) Guideline for the Management of ST-Elevation Myocardial Infarction & 2015 ACC/AHA Focused Update

(Last reviewed 7/2017)

http://circ.ahajournals.org/content/127/4/e362.full

http://content.onlinejacc.org/article.aspx?articleid=2463473

Stroke 

2014 American Heart Association/American Stroke Association; Guideline for Healthcare Professionals on the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

(Last reviewed 7/2017)

 

http://stroke.ahajournals.org/content/45/7/2160


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