Otezla Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

Last verified: May 11, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 11, 2026

Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated May 11, 2026

California - Uniform Prior Authorization FormCalifornia · Updated May 16, 2026

CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 11, 2026

Cigna - General Medication Prior Authorization FormCigna Corporation · Updated May 11, 2026

Colorado - Uniform Prior Authorization FormColorado · Updated May 16, 2026

ICD-10 codes for Otezla Prior Authorizations

L40.50Arthropathic psoriasis, unspecified

L40.51Arthropathic psoriasis, seropositive

L40.52Arthropathic psoriasis, seronegative

L40.53Arthropathic psoriasis, other

L40.0Psoriasis vulgaris

L40.9Psoriasis, unspecified

M35.2Behçet disease

If the payer denies coverage, these templates help you build a stronger appeal.

Letter of Medical Necessity: EnglishLetter of Medical Necessity: English resource

Letter of Medical Necessity: Spanish Letter of Medical Necessity: Spanish resource

A peer-to-peer review with the payer's medical director can often resolve denials faster than a formal appeal.

Pharmacy List Pharmacy List resource

Billing and Coding Guide Billing and Coding Guide resource

Prior Authorization Checklist Prior Authorization Checklist resource

Prior Authorization Checklist: PsAPrior Authorization Checklist: PsA resource

Amgen Support Benefit Verification FormAmgen Support Benefit Verification Form resource

Otezla Start Form (For Specialty Pharmacy Only)Otezla Start Form (For Specialty Pharmacy Only) resource