All Blue Cross and Blue Shield of Alabama 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 annually by the Blue Cross Quality of Care Committee.
Click on the links below to view 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.
Perinatal Care
Guidelines for Perinatal Care, 7th edition, 2012
Source: American College of Obstetricians and Gynecologists, American Academy of Pediatrics
0-21 Years
Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents, 4th Edition, 2017
Source: American Academy of Pediatrics
The Bright Futures/American Academy of Pediatrics (AAP) Recommendations for Preventive Pediatric Health Care, 2017
Source: American Academy of Pediatrics
20-64 Years
Summary of Recommendations for Clinical Preventive Services, January 2017
Source: United States Preventive Services Task Force (USPSTF); American Academy of Family Physicians
65+ Years
Summary of Recommendations for Clinical Preventive Services, January 2017
Source: United States Preventive Services Task Force (USPSTF); American Academy of Family Physicians
Birth to 18 years - Immunizations
Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger
Source: Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices, January 2017
Adults 19 years and older - Immunizations
Recommended Immunization Schedule for Adults Aged 19 Years or Older
Source: Centers for Disease Control and Prevention, Advisory Committee on Immunization Practices, February 2017
Practice Guidelines
Practice Guidelines are systematically developed statements that help practitioners make decisions about appropriate healthcare for specific chronic or acute clinical circumstances.
Diabetes Management
Standards of Medical Care in Diabetes 2017
Source: American Diabetes Association
Diabetes Self-Management Education and Support for Adults with Type 2 Diabetes: Algorithm of Care
Sources: American Diabetes Association, American Association of Diabetes Educators, Academy of Nutrition and Dietetics
Diabetes Self-Management Education and Support for Adults with Type 2 Diabetes: Algorithm Action Steps
Sources: American Diabetes Association, American Association of Diabetes Educators, Academy of Nutrition and Dietetics
Guidelines for Coverage of Diabetes Self-Management Education (DSME) Programs
Cardiovascular Disease Management
My American Heart: Statements and Guidelines
Source: American Heart Association, American Stroke Association and American College of Cardiology
2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults
Source: American Medical Association
Guidelines of Primary Prevention of Stroke, 2014
Source: American Heart Association and American Stroke Association
Aspirin for Primary Prevention of Cardiovascular Events in People with Diabetes, 2010
Source: American Diabetic Association, American Heart Association, and American College of Cardiology Foundation
Attention Deficit/Hyperactivity Disorder Child and Adolescent
Preschool ADHD Diagnosis and Stimulant Use Before and After the 2011 AAP Practice Guideline, 2016
Source: American Academy of Pediatrics
ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents, 2011
Source: American Academy of Pediatrics
ADHD Child and Adolescent Clinical Guideline
Source: American Academy of Child and Adolescent Psychiatry (AACAP) and collaboration with Lucet
Adult Major Depression Guideline for Initial Outpatient Treatment of Adults
Major Depression Guideline for Initial Outpatient Treatment of Adults, 2015
Source: American Psychiatric Association and collaboration with Lucet
Opioid Prescription Management
CDC Guideline for Prescribing Opioids for Chronic Pain, 2016
Source: Centers for Disease Control and Prevention
The information provided within these guidelines is general information and not a guarantee of payment. Benefits are always dependent on whether the service is medically necessary and within the terms of a Blue Cross and Blue Shield of Alabama Member's Benefit Agreement and Blue Cross and Blue Shield of Alabama policies.
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