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AAPC CPB Exam Syllabus Topics:

Section	Objectives
Insurance Processing and Payer Rules	- Coordination of benefits (COB) - Private insurance policies and contracts - Medicare and Medicaid guidelines
Revenue Cycle Management	- Accounts receivable follow-up - Payment posting and reconciliation - Claims denial and rejection management
Medical Billing Fundamentals	- Healthcare reimbursement systems - Medical billing workflow and revenue cycle - Insurance types and payer structures
Coding and Claim Submission Basics	- ICD-10-CM, CPT, and HCPCS overview - Use of modifiers and coding compliance - Claims submission processes
Compliance and Regulations	- Billing compliance standards - Fraud and abuse prevention - HIPAA and patient privacy rules

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AAPC Certified Professional Biller (CPB) Sample Questions (Q106-Q111):

NEW QUESTION # 106
Benefit period (Medicare) __________

A. begins with the first day of hospitalization and ends when the patient has been out of the hospital for 120 consecutive days.
B. begins with the first day of hospitalization and ends when the patient has been out of the hospital for 90 consecutive days.
C. begins with the first day of hospitalization and ends when the patient has been out of the hospital for 60 consecutive days.
D. begins with the first day of hospitalization and ends when the patient has been out of the hospital for 30 consecutive days.

Answer: C

NEW QUESTION # 107
Which is the universal claim form used by physicians offices?

A. Hold Harmless Clause
B. Explanation of Benefits
C. Centers of Medicare and Medicaid Services150 (CMS1500)
D. Health Insurance Claim

Answer: C

NEW QUESTION # 108
American Academy of Processional Coders (AAPC) is professional association established to provide a national certification and credentialing process, to support the national and local membership by providing educational products and opportunities to network, and to increase and promote national recognition and awareness of professional coding.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 109
What is the provider's responsibility when a patient has a copayment?

A. Write it off automatically
B. Bill it to insurance
C. Collect it at the time of service
D. Waive it routinely

Answer: C

Explanation:
Copayments are patient responsibility and should be collected at the time of service.

NEW QUESTION # 110
EQRO

A. External Quality Review Organization
B. Employee Retirements income security Act of 1974
C. First Look Analysis for Hospital Outlier Monitoring
D. Electronic Remittance Advice

Answer: A

NEW QUESTION # 111
......

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