Hi, I am hoping someone may be able to provide some insight. I code for a huge company that has outpatient facilities all across the Unites States. Across the boards (doesn’t seem to matter the state) we have been receiving denials from Medicaid stating a modifier is needed on the procedure. It doesn’t seem to matter if Medicare is primary and pays or if it is Medicaid as the primary and sole payor. The procedures we are billing are debridements (ex. 11042, 97597, etc.) It is not an heirachy issue (ex. billing 11042 & 97597 together)…the denials are simply just when one debridement is being billed. We are thinking it could be LT or RT so have sent a few claims out with that hoping that is the fix, but in case that doesn’t work (don’t have high hopes that it will) I was hoping someone here might know what it could be?? Medicaid will pay the E/M but not the procedure. Any help is greatly appreciated. Thank you!!