Overview
SOMB code 03.04B is paid for the initial prenatal visit, requiring a complete history and complete physical examination. It is prenatal-specific: it cannot be used as a general comprehensive assessment code, and a later routine prenatal follow-up should use 03.03B, not 03.04B.
Billing Requirements
- Initial prenatal visit with the patient
- Complete history including obstetric history
- Complete physical examination
Common Audit Traps
⚠️ Alberta Health auditors specifically look for these mistakes when reviewing 03.04B claims:
- Using 03.04B as a general comprehensive assessment code
- Billing 03.04B more than once for the same pregnancy
Clinical Example
Patient presents for her first prenatal visit; complete obstetric history and full physical performed. Bill 03.04B.
Documentation Tips (Audit-Proof)
- Document the gestational age and relevant obstetric history
- Record the complete physical exam findings
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Related SOMB Codes
Prenatal Visit — In Office
In-office prenatal follow-up visit. Prenatal-specific — does not substitute for a regular 03.03A.
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 Guide