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MA08.021c, Dofetilide (Tikosyn®) Use in the Inpatient Setting
Effective date
Apr 1, 2026
Identified
Jun 19, 2026
Summary
This is a reissue with no substantive changes to Independence Blue Cross Medicare Advantage policy MA08.021c regarding dofetilide (Tikosyn®) coverage in inpatient settings. The policy maintains existing coverage criteria for AF/AFL conversion and maintenance therapy, with required 3-day minimum inpatient stay and continuous ECG monitoring. No billing workflow changes are required.
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What to do
Action · 4 steps
01No action required.
02This is a routine annual policy reissue with no changes to coverage criteria, documentation requirements, or billing procedures.
03Billing team should file this updated version in the policy archive for reference.
04Current billing practices for dofetilide inpatient therapy remain unchanged.
Codes mentioned
I48.11I48.19I48.20I48.3I48.4I48.0
Original notice
MA08.021c, Dofetilide (Tikosyn®) Use in the Inpatient Setting
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →MA08.021c, Dofetilide (Tikosyn®) Use in the Inpatient SettingLowEffective Mar 11, 2024 · PharmacyMA11.060h, Catheter Ablation of Cardiac ArrhythmiasLowNo effective date · Medical PolicyMA11.060h, Catheter Ablation of Cardiac ArrhythmiasLowNo effective date · Medical Policy08.00.49f, Dofetilide (Tikosyn®) Use in the Inpatient SettingLowEffective Apr 1, 2026 · PharmacyBrowse every Independence Blue Cross change in the policy list