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AAPC CPB Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Coding Concepts for Billers12%- ICD-10-CM, CPT®, HCPCS Level II
- Code validation, modifiers
- Medical necessity
Topic 2: HIPAA and Compliance9%- Privacy, security, transaction standards
- Compliance programs
- Medical record retention
- Fraud, abuse, False Claims Act
Topic 3: Billing Regulations13%- Payer payment policies
- CMS-1500, UB-04 completion
- Incident-to billing, global packages
- ACOs, NCCI, LCDs, NCDs
Topic 4: Types of Insurance21%- Commercial payers
- TRICARE/CHAMPUS, Workers' compensation
- Medicare, Medigap, Medicaid
- Managed care plans
- Third-party liability
Topic 5: Claims and Billing14%- Timely filing rules
- Denials, appeals, corrections
- Claim submission, tracking, follow-up
- Electronic claims, clearinghouses
Topic 6: Reimbursement and Collections14%- Refunds, payment plans, write-offs
- Payment posting, adjustments
- Patient statements, collections
- Accounts receivable management
Topic 7: Case Analysis17%- Eligibility verification
- Adjudication and resolution
- End-to-end billing scenarios

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AAPC Certified Professional Biller (CPB) Sample Questions (Q220-Q225):

NEW QUESTION # 220
Which term refers to a digital version of a patient's paper chart, encompassing a comprehensive record of patient health information?

Answer: B


NEW QUESTION # 221
BCBS stands for Blue Cross Blue Shield.

Answer: B


NEW QUESTION # 222
The word root "acr" (or "acro-") refers to:

Answer: A


NEW QUESTION # 223
Which part of the body does genit refer to?

Answer: C


NEW QUESTION # 224
What does the acronym FR stand for?

Answer: C


NEW QUESTION # 225
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