I would recommend you change the wording of your options.
"Evaluate and advise" = consultation
"Test and/or treat" = referral
This makes it much more clear that what the originating physician is asking for is the consultant's advice or opinion on the management of the problem. (The physician who is being consulted MAY still initiate diagnostic testing or treatment for the condition being evaluated.)
So if the PCP sees a patient who has fallen and injured her wrist, and notes on xray that the wrist is fractured, the PCP will send the patient to Ortho with a "test or treat" referral. The PCP doesn't really want Ortho to give the PCP advice on how to treat the broken wrist, he wants the Orthopaedist to treat the fracture.
On the other hand, if the patient comes in with persistent knee pain, the PCP may send the patient to Ortho with a "evaluate and advise" request. The Orthopaedist may decide to order additional diagnostic tests, and may discover a torn meniscus that requires repair, but the original intent of the PCP to seek advice makes the first visit with the Orthopaedist a consultation.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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