We went through the same type of questions and scenarios within our Orthopedic practice. This can become a grey area at times, however, here's my 2 cents.
Scenario 1 and 2 (knee pain and shoulder pain) are somewhat broad symptoms. If the intent of the PCP was to seek an opinion from your Orthopedic providers, I would consider these consults. But again, it really falls on the intent of the PCP's intent and how the PCP documents and conveys this information to your practice.
Scenario 3 and 4. These scenarios seem a little more clearer as to what the patient's plan of treatment should be. It appears that the PCP has established what the problem is and is simply asking the Orthopedic provider to render the treatment...transfer of care=New patient (assuming their new). Again...I'm making an assumption that the PCP has established the plan of care and conveyed to your office that they are requesting managment of care.
I can't emphasize enough the intent of the request. There should be clear communication, either way. I'm not in favor of verbal communication from a PCP to a specialist. I prefer to see it in writing...by way of a form, as an example (transfer of care versus consultation) so that nothing is left unsaid or unturned.
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