Author: Clinical Policy and Programs
Effective Feb. 1, 2018, Clinical Coverage Policy 1A-42, Balloon Ostial Dilation, was revised to include new coverage of CPT code 31298 (balloon dilation of frontal and sphenoid sinus). North Carolina Medicaid will cover this procedure or one of the other Balloon Ostial Dilation (BOD) procedures once per sinus during the beneficiary’s lifetime.
Prior approval for this procedure is required.
Providers will indicate whether the service is being performed unilaterally or bilaterally using modifier –LT (left), -RT (right), or -50 (bilateral). This procedure will be covered in the following places of service:
- Inpatient hospital
- Outpatient hospital
- Ambulatory surgical center, and
- office setting.
Providers should refer to policy 1A-42; Balloon Ostial Dilation, which was posted Feb. 1, 2018.
Clinical Policy and Programs
DMA, 919-855-4260