Botox ultrasound denials

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Dansk2011

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I do most, if not all, of my botox under ultrasound outside of migraine stuff as long as I can, depending on tone/positioning. Spasticity, dystonia, etc. I've recently been getting denials in regard to the ultrasound with certain insurances. Anyone else running into this issue? I did a P2P and the ortho surgeon (not physiatrist) who I spoke with recommended sending in just 1 picture with the note, although he admitted no one would know what they are looking at. Pretty ridiculous especially seeing as if you do emg guidance they don't require audio recordings...

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