Clinical Practice Guidelines

BlueCare Tennessee follows the BlueCross BlueShield of Tennessee Clinical Practice Guidelines (CPG). In addition, BlueCare Tennessee may follow modified guidelines based on conditions relevant to our members, TennCare guidelines or nationally recognized standards when there is not a corporate guideline.

 

BlueCare Tennessee Practice Guidelines

Bipolar Disorder

Schizophrenia

Low Back Pain

A listing of recommendations for evaluating, diagnosing and treating low back pain is available at: Annals of Internal Medicine / Diagnosis and Treatment of Low Back Pain. Click here to view a low back pain diagnostic and treatment flowchart also from the Annals of Internal Medicine website.

 

BlueCare Tennessee CPG Related Tools

Zika Virus Information and Reporting

Learn more about the Zika virus, how to prevent mosquito bites and what mosquito repellents are safe for pregnant women from the Centers for Disease Control and Prevention. The Zika virus has been declared a reportable disease. Visit the Tennessee Department of Health’s website to get more details and how to report a case of the Zika virus.

Recommendations for Preventive Pediatric Health Care

The American Academy of Pediatrics (AAP) continues to emphasize the great importance of continuity of care in comprehensive health supervision and the need to avoid fragmentation of care. Their guidelines are available at the Bright Futures website.

Prevention

The Guide to Clinical Preventive Services, published by the Agency for Healthcare Research and Quality (AHRQ), includes USPSTF recommendations on screening, counseling, and preventive medication topics and includes clinical considerations for each topic.

Obesity

The Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, published by the National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health (NIH), U.S. Department of Health and Human Services, is largely based on the evidence report prepared by the Expert Panel and describes how health care practitioners can provide their patients with the direction and support needed to effectively lose weight and keep it off. It provides the basic tools needed to appropriately assess and manage overweight and obesity. The guide includes practical information on dietary therapy, physical activity, and behavior therapy, while also providing guidance on the appropriate use of pharmacotherapy and surgery as treatment options.

Pharmacotherapy Management of COPD Exacerbation

The Global Initiative for Chronic Obstructive Lung Disease publishes strategy for the diagnosis, management and prevention of COPD, discussing key points and treatment options for management of exacerbations.

+ Manage Exacerbations: Key Points 
+ Manage Exacerbations: Treatment Options

CPG Related Notices

Codeine Risks in Children

The Food and Drug Administration (FDA) has issued two notices about the risks linked to children who take codeine. Providers should consider prescribing alternative analgesics for post-operative pain control in children. There are several very good alternatives. It is also important to emphasize that all drugs have risks. Health care professionals should always weigh the benefits versus the risks before prescribing any medication. For more information, please see the TennCare Drug Safety Alert to Providers.

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