Practice and Preventive Health Guidelines

All BCBSNC guidelines are based on the most current scientific evidence, and are adapted from standards published by nationally recognized authorities. In addition, each guideline is reviewed and approved at least bienially by BCBSNC's Physician Advisory Group.

Click on the links below to download the guidelines.

Preventive Health Guidelines

Preventive Health Guidelines are standards of care developed to encourage the appropriate provision of preventive services to patients, according to their age, gender, and risk-status. These services include screenings, immunizations, and physical examinations.

Oral Health Guidelines

Pregnant Women

Source:American College of Obstetricians and Gynecologists - Oral Health Care During Pregnancy and Through the Lifespan, 2013
Website: http://www.acog.org/~/media/Committee%20Opinions/Committee%20on%20Health%20Care%20for%20Underserved%20Women/co569.pdf?dmc=1&ts=20130724T0007339401
Source: National Maternal and Child Oral Health Resource Center - Oral Health Care During Pregnancy: A National Consensus Statement, 2012
Website: http://www.mchoralhealth.org/materials/consensus_statement.html

Children

Source: American Academy of Pediatrics - Guidelines for Health Supervision of Infants, Children and Adolescents, 2008
Website: http://brightfutures.aap.org/pdfs/Guidelines_PDF/8-Promoting_Oral_Health.pdf
Source: American Academy of Pediatric Dentistry Guideline on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance/Counseling, and Oral Treatment for Infants, Children, and Adolescents, 2013
Website: http://www.aapd.org/media/Policies_Guidelines/G_Periodicity.pdf
Source: American Academy of Pediatric Dentistry - Policy on Use of Fluoride 2013
Website: http://www.aapd.org/media/Policies_Guidelines/P_FluorideUse.pdf

Perinatal care

Source: American College of Obstetricians and Gynecologists, Guidelines for Perinatal Care, 7th edition
Website: http://sales.acog.org/Guidelines-for-Perinatal-Care-Seventh-Edition-P262C54.aspx

0-24 months

Source: American Academy of Pediatrics, Guidelines for Health Supervision of Infants, Children and Adolescents, 2008
Website: http://brightfutures.aap.org/

2-19 years

Source: American Academy of Pediatrics, Guidelines for Health Supervision of Infants, Children and Adolescents, 2008
Website: http://brightfutures.aap.org/

20-64 years

Sources: United States Preventive Services Task Force (USPSTF), Guide to Clinical Preventive Services;
American Academy of Family Physicians, Summary of Recommendations for Clinical Preventive Services
Websites: http://www.uspreventiveservicestaskforce.org/recommendations.htm, http://www.aafp.org/online/en/home/clinical/exam.html

65+ years

Sources: United States Preventive Services Task Force (USPSTF), Guide to Clinical Preventive Services;
American Academy of Family Physicians, Summary of Recommendations for Clinical Preventive Services
Websites: http://www.uspreventiveservicestaskforce.org/recommendations.htm
http://www.aafp.org/online/en/home/clinical/exam.html

All ages - Immunizations

Source: Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices
Website: http://www.cdc.gov/vaccines/

Practice Guidelines

Practice Guidelines are systematically developed statements that help practitioners make decisions about appropriate health care for specific chronic or acute clinical circumstances.

Asthma

Source: National Institutes of Health National Heart, Lung, and Blood Institute-National Asthma Education and Prevention Program Expert Panel Report 3-Guidelines for the Diagnosis and Management of Asthma
Website: www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm 

Attention Deficit/Hyperactivity Disorder

Source: American Academy of Pediatrics
Website: http://pediatrics.aappublications.org/content/128/5/1007.full.pdf
Source: Magellan Health Services
https://www.magellanprovider.com/MHS/MGL/providing_care/clinical_guidelines/clin_prac_guidelines/ADHD.pdf

Source: Magellan Health Services
Attention Deficit Hyperactivity Disorder Tip Sheet

Cholesterol Management

Source: National Institutes of Health National Heart Lung Blood Institute – National Cholesterol Eduation Program. Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)
Website: www.nhlbi.nih.gov/guidelines/cholesterol/index.htm

Depression

Source: American Psychiatric Association
Website: http://psychiatryonline.org/content.aspx?bookid=28&sectionid=1667485 
Depression Screening Tools
Source: U.S. Preventive Services Task Force (USPSTF). Screening for Depression in Adults. December 2009.
Website: www.uspreventiveservicestaskforce.org/uspstf/uspsaddepr.htm

Source: U.S. Preventive Service Task Force (USPSTF). Screening for Major Depressive Disorder in Children and Adolescents. March 2009.
Website: www.uspreventiveservicestaskforce.org/uspstf/uspschdepr.htm

Source: Alere
Website: http://alerecares.com/pl/MultiSiteIncludes/PDF/pdfs/Depression%20Guideline%20Summary%2001-13.pdf

Heart Failure

Source:  ACCF/AHA Guideline for the Management of Heart Failure
Website: http://circ.ahajournals.org/content/128/16/e240.full.pdf+html

Hypertension

Source: National Institutes of Health National Heart Lung Blood Institute - Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)
Website: www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.htm

Overweight and Obesity

Source: National Institutes of Health National Heart Lung Blood Institute - The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults
Website: www.nhlbi.nih.gov/guidelines/obesity/practgde.htm