Medicare AdvantageCoverageMedium impact
MA08.021c, Dofetilide (Tikosyn®) Use in the Inpatient Setting
Independence Blue Cross·Cardiology, Critical Care, Internal Medicine +1 more·Pharmacy
Effective date
Mar 5, 2025
We identified it
Jun 19, 2026
Summary
Policy MA08.021c has been reissued effective 03/05/2025 regarding Dofetilide (Tikosyn®) use in the inpatient setting. This is a pharmacy policy for Medicare Advantage plans that establishes coverage and utilization guidelines for this antiarrhythmic medication in hospital settings. The billing team must ensure claims for inpatient dofetilide administration comply with the updated policy requirements.
Action Required
By 03/05/2025: Billing team must review the complete policy text at the provided URL to identify specific coverage requirements, prior authorization mandates, and documentation needs for inpatient dofetilide claims. Update internal billing guidelines and train staff on any new requirements. Ensure billing system reflects any new authorization or documentation requirements. Verify that all inpatient dofetilide claims submitted after the effective date comply with the reissued policy to avoid denials. Clinical staff should be notified of any new provider documentation or ordering requirements established in this policy.