We had this exact same scenario and our Compliance office stated that we should code the first billable service with the new patient code. (The resident may be a part of your Ortho team, but the resident is not being paid by your practice.)
If it is a commercial payor ... you may be able to bill for the fracture care provided by the resident under the supervision of a teaching physician. Our commercial carriers do not require physical presence of the TP - supervision can be by any means of modern communication including fax and phone for the commercial payors.
F Tessa Bartels, CPC, CEMC
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