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Clinical Practice Guidelines

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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 the Company’s behavioral health committees. Further, while authoritative sources are consulted 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/her Policy or Certificate and Schedule of Benefits for details concerning benefits, procedures and exclusions prior to receiving treatment. The practice guidelines do not supersede the Policy or Certificate and Schedule of Benefits.  
Asthma (reviewed/approved 5/2012)
National Heart Lung and Blood Institute - National Asthma Education and Prevention Program (NAEPP), Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma, Full Report 2007
 
Attention-Deficit/Hyperactivity Disorder (ADHD) (reviewed/approved 4/2014) 
American Academy of Pediatrics. ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/ Hyperactivity Disorder in Children and Adolescents 
 
CAD - Coronary Artery Disease (General Population and in Women) (reviewed/approved 5/2012)
American Heart Association - http://circ.ahajournals.org/content/124/22/2458
American Heart Association - Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease: A Scientific Statement From the American Heart Association for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention. Circulation 2007;115;2761-2788
American Heart Association - Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women 2011 Update: A Guideline from the American Heart Association. Circulation 2011; 123; 1243-1262; originally published online February 14, 2011.
 
Chronic Kidney Disease (Transplant) (Reviewed/approved 11/2012 - Re-approve 12/2013)
Kidney Disease Outcomes Quality Initiative (KDOQI) 2002.
 
Chlamydia/HPV (reviewed/approved 2/2012)
Centers for Disease Control and Prevention (CDC) - Sexually Transmitted Diseases – Treatment Guidelines 2010
 
COPD - Chronic Obstructive Pulmonary Disease (reviewed/approved 10/2013)
 
Diabetes – (reviewed/approved 2/2013)
American Diabetes Association.-American Diabetes Association – Clinical Practice Recommendations 2011 Diabetes Care, Vol. 34, Supplement 1, January 2011.
2013 Standards of Care - http://care.diabetesjournals.org/content/36/Supplement_1/S11.full
2013 Standards of Care Evidence Table - http://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/Evidence%20Table%20for%202013%20ADA%20Standards%20of%20Care.pdf
 
Heart Failure – (reviewed/approved 8/2013)
2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines http://content.onlinejacc.org/article.aspx?articleid=1695826
 
HIV/AIDS (Reviewed/approved 11/2012 - Re-approve 12/2013)
Primary Care Guidelines for the Management of Persons Infected With HIV: 2013 Update by the HIV Medicine Association of the Infectious Diseases Society of America
 
Hypertension in Child and Adolescent (Reviewed/approved 11/2012 - Re-approve 12/2013)
The Fourth Report on Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. 2005
 
Maternity/Perinatal –(reviewed/approved 2/2013)
American Academy of Pediatrics  
American College of Obstetricians and Gynecologists  
Perinatal Guideline Summary based on the 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
 
Obesity in Adults (Reviewed/approved 11/2012 - Re-approve 12/2013)
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report to the American College of cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. 2013  
Guideline for the Management of Overweight and Obesity in Adults
 
Obesity in Children (Reviewed/approved 11/2012 - Re-approve 12/2013)
Expert Committee recommendations regarding the prevention, Assessment, and treatment of Child and Adolescent Overweight and Obesity: Summary report. 2007.
 
Vascular at Risk – Hyperlipidemia (reviewed/approved 9/2012)
National Heart Lung and Blood Institute - National Cholesterol Education program Expert Panel. Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) NIH, NHLBI; May 2001, NIH Publication No. 02-5215.
National Heart Lung and Blood Institute - National Cholesterol Education Program Expert Panel. Implications of Recent Clinical Trials for the NCEP Adult Treatment Panel III Guidelines; Circulation. 2004;110:227-239
 
Vascular at Risk – Hypertension (reviewed/approved 9/2012)
National Heart Lung and Blood Institute - Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) National Institutes of Health (HIH), National Heart, Lung and Blood Institute. August 2004; NIH Publication No. 04-5230
 
Last Update: 4/25/14 
 
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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use