# Billing for residents procedures in the ED



## mariadifuccia (Mar 13, 2013)

Can an ED physican bill for a procedure done by a resident who was called for a specialty consult? For example, The patient comes to the ED for a tibial fracture. A consult is called and an ortho resident performs a closed reduction. Can the ED physican bill for that procedure? If not, who can bill for the closed reduction?


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## FTessaBartels (Mar 13, 2013)

*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


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