64451 prior authorization | Blue Cross and Blue Shield of Montana

64451, Injection(S) Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint With Image Guidance (Ie Fluoroscopy Or Computed Tomography), is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 64451
Description: Injection(S) Anesthetic Agent(S) And/Or Steroid; Nerves Innervating The Sacroiliac Joint With Image Guidance (Ie Fluoroscopy Or Computed Tomography)
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 66 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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