CPT 64451 · SI Joint · Liberty Mutual / Helmsman WC
SI Joint Nerve Block (S1–S3 lateral branches) at Liberty Mutual / Helmsman WC.
How Liberty Mutual / Helmsman WC approaches CPT 64451 (SI Joint Nerve Block (S1–S3 lateral branches)) for prior-authorization review: at last review on 2026-05-09, the policy covers this code without prior authorization.
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Criteria summary
High-level themes from the Liberty Mutual / Helmsman WC policy of record for CPT 64451. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: Liberty Mutual / Helmsman WC Workers' Compensation Medical Treatment Guidelines
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