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CommercialPrior AuthMedium impact

Topical Antifungals: Ertaczo, Exelderm

Blue Cross & Blue Shield of Mississippi·MS · Dermatology, Family Medicine, Internal Medicine +1 more·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

This policy establishes prior authorization requirements for topical antifungals Ertaczo and Exelderm. Prior auth is required for all requests, with specific age and diagnosis criteria, plus mandatory trial/failure of at least two generic topical antifungals before approval.

Action Required

Action needed
Immediately: Billing team must update prior authorization workflows for Ertaczo and Exelderm prescriptions. Ensure providers document patient age, specific fungal diagnosis, and trial/failure of at least two generic topical antifungals (ciclopirox, econazole, ketoconazole, oxiconazole) before submitting prior auth requests. Maximum approval length is 4 weeks with no renewals. Claims will be denied without proper prior authorization.