I guess I would want to see the orthopedic note before answering the question. I wonder why the private MD was involved, other than for insurance purposes? I work for a group of orthopedic surgeons. We get patients all the time who are referred for fracture treatment.....sometimes surgical and sometimes non-surgical. The only time we may charge a consultation (non-Medicare patient) is if one of our providers actually goes to the ED. Otherwise, we normally would consider it a "transfer of care". But having the private MD involved complicates it a little bit.
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