Free PDF Quiz 2026 CPB: Trustable Reliable Certified Professional Biller (CPB) Exam Guide

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AAPC CPB Exam Syllabus Topics:

Section	Weight	Objectives
Billing Regulations	13%	- ACOs, NCCI, LCDs, NCDs - CMS-1500, UB-04 completion - Payer payment policies - Incident-to billing, global packages
Case Analysis	17%	- End-to-end billing scenarios - Eligibility verification - Adjudication and resolution
Claims and Billing	14%	- Denials, appeals, corrections - Claim submission, tracking, follow-up - Timely filing rules - Electronic claims, clearinghouses
Reimbursement and Collections	14%	- Payment posting, adjustments - Refunds, payment plans, write-offs - Accounts receivable management - Patient statements, collections
HIPAA and Compliance	9%	- Medical record retention - Privacy, security, transaction standards - Compliance programs - Fraud, abuse, False Claims Act
Types of Insurance	21%	- Commercial payers - Third-party liability - TRICARE/CHAMPUS, Workers' compensation - Medicare, Medigap, Medicaid - Managed care plans
Coding Concepts for Billers	12%	- ICD-10-CM, CPT®, HCPCS Level II - Code validation, modifiers - Medical necessity

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AAPC Certified Professional Biller (CPB) Sample Questions (Q186-Q191):

NEW QUESTION # 186
What is All Patient DiagnosisRelated Group (APDRG)?

A. Adopted by Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries; expanded original DRG system (based on intensity of resources) to add two subclasses to each DRG that adjusts Medicare inpatient hospital reimbursement rates for severity of illness (SOI) (extent of physiological decompensation or organ system loss of function) and risk of mortality (ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme.
B. DRG system adapted for use by third-party payers to reimburse hospitals for inpatient care provided to nonMedicare beneficiaries (e.g. Blue Cross BlueShield, commercial health plans, TRICARE); DRG assignment is based on intensity of resources.

Answer: B

NEW QUESTION # 187
arthr

A. two
B. joint
C. condition

Answer: B

NEW QUESTION # 188
HAVEN stands for Home Assessment Validation and Entry.

A. TRUE
B. FALSE

Answer: A

NEW QUESTION # 189
Preauthorization is an authorization that must be received from a payer before treatment by a specialist will be covered.

A. TRUE
B. FALSE

Answer: A

NEW QUESTION # 190
What does the acronym ERISA stand for?

A. Fair Debt Collection Practices Act
B. Employee Retirements Income Security Act of 1974
C. First Look Analysis for Hospital Outlier Monitoring
D. False Claims Act

Answer: B

NEW QUESTION # 191
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