D0411 - HbA1c Test

HbA1c in-office point of service testing.

Procedure Code
D0411
Category
Diagnostic

Insurance Verification Benchmarks & Billing Guidelines

Benchmark Policy Source: Delta Dental 2026

Frequency Limitation
Subject to group/individual contract frequency limitations (none)

Required Claim Attachments & Pre-Submission Checklist

  • Standard ADA claim form with CDT procedure code and date of service

Bill When (Allowable Clinical Criteria)

  • When covered by group/individual contract, benefits are limited to one test per benefit year.

Restrictions & Clinical Exclusions

  • Benefits are denied unless covered by group/individual contract.
  • When D0411 is submitted on the same date/same dentist/dental office as D0412 (blood level glucose level test), the fee for D0412 is not billable to the patient.

Common Claim Denial Codes & Overturn Strategies

Denial CodeDenial ReasonAppeal & Overturn Strategy
CO-119Benefit maximum or frequency limitation exceeded for procedureSubmit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria.

ICD-10 Justification & Crosswalk Mappings

ICD-10 CodeDiagnosis NameCategoryPrimary JustificationClaim TypeClinical Scenario