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08.00.49f, Dofetilide (Tikosyn®) Use in the Inpatient Setting
Effective date
Apr 1, 2026
Identified
Jun 19, 2026
Summary
Independence Blue Cross reissued policy 08.00.49f with no substantive changes to dofetilide (Tikosyn®) coverage for inpatient use. The policy maintains coverage for AF/AFL conversion and NSR maintenance when initiated/escalated/reinitiated in an inpatient setting with continuous ECG monitoring for minimum 3 days, and continues to exclude paroxysmal AF as not medically necessary.
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What to do
Action · 4 steps
01No immediate action required.
02This is a routine annual reissue with no coverage changes.
03Billing and clinical staff should note the most recent effective date (04/01/2026) for future reference.
04Verify that current claim submission practices already align with the documented requirements: inpatient admission confirmation, minimum 3-day continuous ECG monitoring documentation, and exclusion of paroxysmal AF (I48.0) claims from coverage.
Codes mentioned
I48.11I48.19I48.20I48.3I48.4I48.0
Original notice
08.00.49f, 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 PolicyMA08.021c, Dofetilide (Tikosyn®) Use in the Inpatient SettingLowEffective Apr 1, 2026 · PharmacyMA11.060h, Catheter Ablation of Cardiac ArrhythmiasLowNo effective date · Medical PolicyBrowse every Independence Blue Cross change in the policy list