Do any of your providers belong to AAOS, ASSH, AANS or any of the other specialty societies with contacts there? It sounds like this is more widespread. What years are the claims from? Is it only 2024 year?
Have you checked provider newsletters, bulletins, and claim issue alerts for these payers?
Instead of going to the customer service claims people, I would go to my provider representatives. I don't work on the provider side anymore so I don't have current info on it.
If you are ortho, I would suggest also reaching out to KZA if you have contacts there or have interacted to see what they have heard or seen. The orthopedic coding conferences are/will be going on so they may have info on this from across the country.
Are they paying everything except the Q code? Or, are they denying the casting also and due to that, then also denying the Q code?
If this is across so many payers and states, there had to be a change or something like a modifier required or they are all taking a policy out of context. I would suggest our RCM data analytics or management running reports to quantify the scope of it.
Have you read the "fracture care" policies for the payers in question? This is where you can find the casting info sometimes.
Example:
https://www.bluecrossmn.com/sites/default/files/DAM/2023-07/medicare-si-006-fracture-care.pdf
Supplies No additional reimbursement will be made for surgical trays, surgical or other miscellaneous supply codes A4550, A4649, and 99070. The allowance for these codes is considered bundled into payment for the other services rendered.
If the cast, splint, or strapping is applied in the office, supplies may be billed separately with the appropriate HCPCS codes (Q4001-Q4051). Cast, splint, and strapping supplies provided in a facility place of service are not reimbursable as they are considered to be included in the facility’s reimbursement for services provided. Other supplies used in the office place of service are generally considered incidental or bundled into payment for any other service performed.