Overview
SOMB code 03.08A is paid for a comprehensive in-office consultation at the request of another physician. Like 03.04A it requires a complete history and complete physical exam — but it is billed only in the context of a referral and must include a written consult report back to the referring physician. It is the correct code when the referred problem requires a full work-up.
Billing Requirements
- Written or electronic referral from another physician
- Complete history and complete physical examination performed
- Written consult report sent back to the referring physician
Common Audit Traps
⚠️ Alberta Health auditors specifically look for these mistakes when reviewing 03.08A claims:
- Billing 03.08A without a documented referral
- Billing 03.08A without the complete history and complete exam required for a comprehensive assessment
- Billing 03.08A and 03.04A together for the same visit
Clinical Example
Physician refers a patient with a multi-system problem requiring a full work-up. Complete history and physical performed; detailed consult report sent back. Bill 03.08A.
Documentation Tips (Audit-Proof)
- Keep the referral and the consult report together in the chart
- Document the complete history and full physical exam in detail
- Record the clinical opinion and recommendations returned to the referring physician
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Related SOMB Codes
Minor Consultation — In Office
Minor in-office consultation performed at the request of another physician. Lower complexity than 03.08A.
Read GuideComprehensive Assessment — In Office
Comprehensive in-office assessment requiring a complete history and a complete physical examination. Use only when documentation actually supports a full workup.
Read GuideLimited Assessment — In Office
Limited assessment of a patient's condition requiring a history related to the presenting problems, a directed examination, and advice. The default GP office visit code.
Read Guide