Supervising Physician
The supervising physician for an Ortho resident would be the Orthopaedic surgeon. If that physician was not physically present in the ED, and the patient is covered by a payer that required face-to-face involvement (i.e. Medicare, Medicaid, Tri-care, etc) then no one gets to bill.
If the patient is covered by a commercial carrier that allows "supervision by any means," AND the resdent documented conversation with the attending Orthopaedic surgeon, who has confirmed and signed the note, then you may be able to bill the fracture care under the Ortho surgeon's name.
As per usual ... it all depends on the documentation (and the carrier's policies).
Hope that helps.
F Tessa Bartels, CPC, CEMC