BlueChoice HealthPlan

Clinical Practice Guidelines

Clinical Practice Guidelines

The practice guidelines included on this website are not intended to be required treatment protocols. Physicians and other health professionals must rely on their own expertise in evaluating and treating patients. Practice guidelines are not a substitute for the best professional judgment of physicians and other health professionals. Behavioral health guidelines may include commentary developed by our behavioral health committees.

Further, while we consult authoritative sources in the development of these guidelines, the practice guideline may differ in some respects from the sources cited. With respect to the issue of coverage, each patient should review his or her Policy or Certificate and Schedule of Benefits for details concerning benefits, procedures and exclusions before receiving treatment. The practice guidelines do not supersede the Policy or Certificate and Schedule of Benefits.

Asthma (reviewed 5/17/12)

• National Heart, Lung, and Blood Institute
  • Guidelines for the Diagnosis and Management of Asthma (EPR 3 Summary Report 2007)

 

Chlamydia (reviewed 2/12, approved 3/12)

• Centers for Disease Control and Prevention (CDC)
  • http://www.cdc.gov/std/treatment/2010

 

Chronic Heart Failure (CHF) (in the Adult) (reviewed 5/17/12)

• American Heart Association/American College of Cardiology
  • 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines (Circulation, April 14, 2009) 

 

Chronic Obstructive Pulmonary Disease (COPD) (reviewed/approved 2/13)

• Global Initiative for Chronic Obstructive Lung Disease (GOLD) 
  •  

 

Coronary Artery Disease (reviewed and approved 9/1/12)

• Circulation - AHA/ACCF Guideline

 

Diabetes (reviewed/approved 2/13)

• American Diabetes Association
  • 2013 Standards of Care 
  • Evidence Table: Standards of Medical Care in Diabetes - 2013

 

High Blood Cholesterol (reviewed 9/11)

• National Institutes of Health (NIH)
  • Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

 

Human Papillomavirus (HPV) (reviewed 2/12)

• Centers for Disease Control and Prevention (CDC)
  • Sexually Transmitted Diseases - Treatment Guidelines 2010 (Human Papillomavirus Infections)

 

Hypertension (High Blood Pressure) (reviewed 9/11)

• National Heart, Lung, and Blood Institute
  • High Blood Pressure Guidelines (JNC 7)

 

Maternity and Perinatal (reviewed/approved 2/13)

• Guidelines for Perinatal Care, 7th edition, 2012, American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) 
• Summary of Perinatal Care Guidelines 2013

 

Vascular At Risk(Reviewed and Approved 9/1/2012)

• Vascular at Risk - Hypertension
• Vascular At Risk - Hyperlididemai