I would love to get some feedback on how other practices are billing for OB ultrasounds. We are encountering more and more denials. Our usual policy is to do the first US at 1st ob visit (6 weeks) and then we do an 18 week scan on all patients. The problem is that some ins companies only pay for 1 per pregnancy and since the 6 week one is billed first they don't pay for the more ceomprehensive one at 18 weeks. It also is a matter of proving medical necessity when there are no abnormal findings. Does anyone make the patient sign an ABN and charge the patient if denied? Thanks very much for any input!