Tony Palcaorolla, the first-ever Medicare bene. With President Lyndon B. Johnson in 1965.

This free podcast gives you a unique perspective on the coding or billing job you do every day.

I don’t know about you, but do you ever look up from the coding work on your desk and wonder how we got here? Who invented codes? Who came up with Relative Value Units (RVUs)? Why wasn’t “medical coding” even a job 20 years ago?

While health care reimbursement may seem dull to outsiders, it is a twisted tale of political blunders, greed, and insider influence — and you can get the lowdown on the job you do every day as you fold the laundry or do the dishes during the coming week.

Bonus: The podcast matches each Medicare era with a popular song. Can you guess what was going on with health care reimbursement when the Captain and Tennille’ had a hit?

To get a whole new perspective on your medical reimbursement job, listen to this free, 20-minute Paying Doctors podcast from the good folks at National Public Radio’s ‘Planet Money.’

One podcast highlight — the history of the RVU, which was first created in the late 1980’s by Harvard economist William Hsiao and adopted by Medicare in 1992. Before the RVU, doctors simply told Medicare what they thought they should be paid. Can you imagine that now?

“Hsiao brought in doctors and asked them to rate every single thing they did based on how technically hard it was, how stressful, how much the supplies cost, etc.,” explains the podcast intro. And that’s the RVU system still attached to procedure codes today. Special interest groups hovered over Hsiao’s work, and in his opinion, watered down the RVU system so much that it never cut costs.

To listen to the podcast, go here.

Guess what? The health care reform bickering in Washington today will affect your job tomorrow. Learn more here.

Is the Medicare Physician Fee Schedule like Greek to you? Relax. We’ll explain it to you in plain English.

What, exactly, is the Medicare Physician Fee Schedule? I used to wonder that when I first entered the world of coding and billing. The whole big truth of it seemed like such a mystery that for a few years I (sort of) faked what I knew about the MPFS because it seemed like such a basic question with such daunting answers.

Well, here at My Coding Career we can just learn without posing. Consider this your VERY BASIC guide to the Fee Schedule — whether you’re new brand new to coding or whether, like me, you’ve worked for awhile without having the overall picture.

Every year, the MPFS outlines the rates physician practices will get for the work that they do (with some extra money for practice expenses and malpractice insurance supposedly built in).

Under the Fee Schedule, each CPT® code is assigned a relative value unit, or RVU. The RVUs are adjusted based on the practice’s geographic location — because expenses like the practice’s rent vary across the country. The conversion factor is the national dollar amount multiplied by the geographically adjusted RVU. The fee schedule is a big deal because that’s where Medicare sets reimbursement (and lots of other payers follow suit). It’s also the place where CMS makes a lot of rules for your practice to follow if you bill Medicare.

A draft revised fee schedule comes out every July for the following year, and CMS gives us all a public comment period when we can complain about it. That’s when you hear specialty societies ask to be paid more, not less. The final rule comes out Nov. 1. It sits around here until Nov. 10, when it’s published in the Federal Register. It takes effect January 1, 2010.

What? My physicians are getting a 21 percent pay cut? When you read the announcement from CMS about the final 2010 fee schedule, it may seem like physicians are getting their payments cut by 21 percent. Don’t wig out like I did the first few times I saw the fee schedule come out. CMS has to put that in because they’re supposed to be following an old law that doesn’t work very well. Congress always comes in at the last minute and restores the pay cut, and they’ll probably do that again this year.

Your cocktail party conversation about the MPFS: If you want to sound smart or, okay, help your practice prepare for one of the biggest fee schedule changes in recent years, understand that the 2010 fee schedules axes consultation coding and, generally, increases reimbursement for primary care while dramatically decreasing reimbursement for certain diagnostic imaging procedures.

Tip: You can also use the Medicare Physician Fee Schedule as a cool tool to help prevent denials. Learn the moves here.

Have more questions about how to read the fee schedule? Write me and I’ll show you the ropes, or, more likely, find someone who can. Or, if you have other coding topics you’d like us to cover in ‘My Skill Sharpener,’ write us and ask!