Overview
SOMB code 03.05JR is paid for a physician-initiated telephone call directly to a patient to discuss patient management or diagnostic test results. It is not a substitute for a full assessment (03.03CV) — it is specifically for results or management communications. Alberta Health applies frequency and eligibility limits to 03.05JR; review the current SOMB text before relying on it.
Billing Requirements
- Physician-initiated telephone call directly to the patient
- Discussion of patient management or diagnostic test results
- Clinical content documented in the chart
Common Audit Traps
⚠️ Alberta Health auditors specifically look for these mistakes when reviewing 03.05JR claims:
- Billing 03.05JR for a call placed by clinic staff rather than the physician
- Billing 03.05JR for the same content already billed as 03.03CV that day
- Exceeding SOMB frequency restrictions on telephone management codes
Clinical Example
Physician calls a patient with the result of a recent blood test, discusses the implications and a medication change. Document the content and bill 03.05JR.
Documentation Tips (Audit-Proof)
- Record the date and time of the call and who spoke with the patient
- Summarise the clinical discussion and any decisions made
- Note any next steps or follow-up arranged
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Related SOMB Codes
Assessment via Telephone or Secure Videoconference
Assessment of a patient's condition conducted via telephone or secure videoconference. Substantive clinical work only — not for admin or results-only calls.
Read GuideTelephone Advice to Patient or Agent
Advice provided to a patient or their agent (as defined in the Personal Directives Act) via telephone. Strict SOMB rules apply — read the full text before billing.
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