By March 24, 2026: Billing team must implement the following controls in billing software and claim submission processes: (1) Flag and deny claims for more than 1 detailed fetal anatomic ultrasound (CPT 76811, 76812) per trimester per pregnancy as non-covered; (2) Require documentation of medical necessity before processing CPT 76811/76812 claims—reject claims lacking qualifying diagnoses from the ICD-10 list (O35.*, O36.*, E66.01/09, A92.5, B06.*, B50-B54, O09.5*, O09.8*, O24.*, O28.5, O30.*, O31.*, G93.5, or documented special conditions like IVF, Zika exposure, syphilis, obesity BMI≥30); (3) Deny all claims for CPT 76811/76812 billed with non-medical-necessity indications (routine screening, sex determination, septate/arcuate uterus, family history of CHD, maternal myasthenia gravis, low PAPP-A, smoking/cannabis use, bupropion/levetiracetam use, spironolactone exposure, or other experimental indications listed); (4) Auto-deny 3D/4D ultrasound requests; (5) Educate providers that transvaginal ultrasound (TV-US) includes pelvic ultrasound—do not bill both separately. Update encounter forms to capture trimester and specific medical indication. Providers must document one of the covered indications (fetal anomaly suspected, aneuploidy markers, IVF pregnancy, maternal obesity, known infections, uterine anomalies, prior pregnancy with anomaly, etc.). Failure to enforce these limits will result in claim denials and potential recovery actions.