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| Section | Weight | Objectives |
|---|
| CPT Coding | 20-25% | - CPT code categories and structure - Evaluation and Management (E/M) codes - Modifiers and their appropriate use - Category II and III codes - Surgical procedure codes
|
| ICD-10-CM Diagnosis Coding | 15-20% | - Chapter-specific guidelines - Secondary diagnosis coding - Principal diagnosis selection - Code accuracy and specificity - ICD-10-CM structure and conventions
|
| Healthcare Billing Fundamentals | 15-20% | - Revenue cycle overview - Anatomy and physiology for billers - Healthcare documentation principles - Medical terminology basics
|
| Billing Compliance and Regulations | 10-15% | - Documentation compliance - Stark Law and Anti-Kickback Statute basics - Appeal and denial management - Fraud, waste, and abuse prevention - HIPAA privacy and security requirements
|
| Practice Management | 10-15% | - Patient registration and demographics - Patient responsibility calculations - Collections and payment posting - Insurance verification processes - Accounts receivable management
|
| Insurance and Reimbursement | 20-25% | - Workers' compensation and no-fault billing - Commercial insurance policies - Fee schedules and reimbursement methodologies - Coordination of benefits - Claims submission and processing - Government payers (Medicare, Medicaid, TRICARE)
|
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AAPC Certified Professional Biller (CPB) Sample Questions (Q203-Q208):
NEW QUESTION # 203
ilio
- A. within, into
- B. in, into, not
- C. between
- D. ilium (hip bone)
Answer: D
NEW QUESTION # 204
CNS
- A. Certified Professional Coder
- B. Coordination of Benefits
- C. Clinical nurse specialist
- D. Consolidated Omnibus Budget Reconciliation Act of 1985
Answer: C
NEW QUESTION # 205
Which part of the body do gaster and gastr refer to?
- A. stomach
- B. genitals
- C. intestine
- D. tongue
Answer: A
NEW QUESTION # 206
What does it mean by gyn, gyne and gynec?
- A. women, female
- B. men, male
Answer: A
NEW QUESTION # 207
DMEPOS
- A. Department of Defense
- B. Diagnosis related groups
- C. Durable Medical Equipment, Prosthetic and Orthotic Supplies
- D. Durable Medical Equipment regional carriers
Answer: C
NEW QUESTION # 208
......
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