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AetnaCommercial · Coverage · Medical Policy · Dermatology, PediatricsMedium impact

Cantharidin (Ycanth) (CPB 1051, reviewed 2025-12-23)

Effective date
Not stated in the notice
Identified
Aug 12, 2026

Summary

Cantharidin (Ycanth) is considered medically necessary for commercial medical plans for the topical treatment of molluscum contagiosum when all criteria are met: the member is 2 years of age or older, the member has a diagnosis of molluscum contagiosum, Ycanth is not used for oral, mucosal, or ophthalmic lesions, a healthcare professional who has received instruction and training administers it, and no more than 2 applicators are used in a single treatment session. Continuation of therapy is considered medically necessary for up to 4 treatment sessions (cycles) per infection when the same criteria are met. More than 4 treatment sessions and use for members under 2 years of age are considered experimental, investigational, or unproven, and all other indications are considered experimental, investigational, or unproven.

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What to do

Action · 4 steps
01Bill HCPCS J7354 with ICD-10 B08.1 only when the criteria are met: the member is 2 years of age or older, the diagnosis is molluscum contagiosum, Ycanth is not used for oral, mucosal or ophthalmic lesions, a trained healthcare professional administers it, and no more than 2 applicators are used in a single treatment session.
02ICD-10 B08.1 is covered only when these selection criteria are met.
03Limit treatment to a maximum of 4 treatment sessions (cycles) per infection.
04More than 4 sessions, and use for members under 2 years of age, are considered experimental, investigational, or unproven.

Codes mentioned

J7354B08.11711017111

Original notice

Cantharidin (Ycanth) (CPB 1051, reviewed 2025-12-23)
aetna.com · Always check the source before changing claims.
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