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AAPC CPB Exam Syllabus Topics:

Section	Weight	Objectives
CPT Coding	20-25%	- Surgical procedure codes - Evaluation and Management (E/M) codes - Category II and III codes - Modifiers and their appropriate use - CPT code categories and structure
Billing Compliance and Regulations	10-15%	- Documentation compliance - Stark Law and Anti-Kickback Statute basics - Fraud, waste, and abuse prevention - Appeal and denial management - HIPAA privacy and security requirements
Practice Management	10-15%	- Patient responsibility calculations - Accounts receivable management - Insurance verification processes - Collections and payment posting - Patient registration and demographics
Insurance and Reimbursement	20-25%	- Workers' compensation and no-fault billing - Claims submission and processing - Government payers (Medicare, Medicaid, TRICARE) - Commercial insurance policies - Fee schedules and reimbursement methodologies - Coordination of benefits
ICD-10-CM Diagnosis Coding	15-20%	- Code accuracy and specificity - Chapter-specific guidelines - Principal diagnosis selection - ICD-10-CM structure and conventions - Secondary diagnosis coding
Healthcare Billing Fundamentals	15-20%	- Revenue cycle overview - Healthcare documentation principles - Medical terminology basics - Anatomy and physiology for billers

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AAPC Certified Professional Biller (CPB) Sample Questions (Q72-Q77):

NEW QUESTION # 72
What does it mean by gluc and glyc?

A. fat
B. sugar, glucose
C. vitamins
D. protein

Answer: B

NEW QUESTION # 73
CMS

A. UB04 Claim used by institutional and other selected providers to bill payers
B. Clinical nurse specialist
C. Centers of Medicare and Medicaid Services
D. Insurance claim used by noninstitutional providers and supplier to bill payers

Answer: C

NEW QUESTION # 74
ABN stands for Advance Beneficiary Notice.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 75
Adjudication

A. Payment correction resulting in additional payment(s) to the provider.
B. Document that acknowledges patient responsibility for payment if Medicare denies the claim
C. Judicial dispute resolution process in which an appeals board makes a final determination.
D. Also called adverse reaction; the appearance of a pathologic condition due to ingestion r exposure to a chemical substance properly administered or taken.

Answer: C

NEW QUESTION # 76
Current Procedural Terminology (CPT) is used to report professional services to payers.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 77
......

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