Balloon Ostial Dilation (BOD) Services Billed with Modifier 50 (Bilateral)

It has come to NC Medicaid’s attention that claims for balloon sinus ostial dilation billed with modifier 50 (bilateral), were resulting in an under payment to providers. The issue has been resolved. Providers with claims for the following procedures billed with modifier 50 on or after July 29, 2018, should resubmit their claims for reprocessing. The procedures are:

• 31295 (nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium),
• 31296 (nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium), and
• 31297 (nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium).