How D0411 is disrupting the current total health model

According to the CDC, 29 million people are living in the US with diabetes, with only one out of four being diagnosed. Even more staggering, 85 million people in the US are pre-diabetic, with only one in ten aware that they are actively developing an insulin resistance to the hormone crucial in regulating blood glucose, putting each of them at an increased risk of becoming diabetic.


The dental industry is sitting in a dynamic space with the continued evolution of oral health and it’s ever present, augmented impact on overall health. Every year we are given new studies, tools, and CDT codes that catapult our industry into an innovative space ultimately bringing more crucial services to dentistry.


In 2018, a dynamic new code was released – D0411 Diabetes Screening for HbA1c. This code was designed to allow providers the opportunity to integrate a total health approach in treating today’s dental patient. As we shift our best practices towards the total health model, it is crucial that we also begin to shift our mindset and verbiage as to how these procedures will benefit our patients.


Utilizing D0411 testing regularly will evaluate and identify symptomatic and asymptomatic diabetic patients and offer providers more insight into patient outcomes. Glucose screening identifies elevated blood sugar levels that could possibly inhibit proper healing, due to the stiffening of arteries and narrowing a blood vessel. Infections, delayed healing and periodontal disease are all areas in which proper screening for diabetes can aid clinicians in better patient management.


During the most crucial step in our patient flow, reviewing the patient’s medical and dental history, is when we analyze patient data and project the most attainable and successful treatment outcomes. Incorporating glucose screening into this process – during the new patient appointment, recare visit and before dental surgery – will allow dentists to gain knowledge of possible undiagnosed or uncontrolled diabetic patients.


Screening patients is simple and can be completed chairside with an HbA1c glucose monitor. This monitor specifically evaluates a patient’s A1c, which is the average level of blood sugar level over the past 2 to 3 months, giving a more definitive baseline indicator. The procedure code does not describe simple testing of the patient’s blood sugar levels. The procedure can be completed at minimal charge to the patient and at a frequency deemed necessary by the dental clinician. D0411 would not generally be paid by conventional dental plans, but should be considered for possible medical reimbursement. With the proper protocols in place including appropriate referrals to primary care, this can aid in the diagnosis of pre-diabetes and diabetes.


Incorporating any new procedure can seem daunting, Nelson Mandala said it best, “it always seems impossible, until it is done.” With the proper protocols and support, D0411 Diabetes Screening for HbA1c can and will become a routine part of your patient’s total health dental experience.


Tarah Grauer has over 16 years of experience in the dental industry as a practicing dental hygienist,  office manager and dental assistant. After a successful clinical career, Tarah joined Henry Schein Dental as a practice development coach. She now provides coaching and systems implementation with a hands-on approach that increases production and reduces stress. Visit to learn more. For a free consultation, contact her at tarah.grauer