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AAPC CPB Exam Syllabus Topics:

Section	Weight	Objectives
Topic 1: ICD-10-CM Diagnosis Coding	15-20%	- ICD-10-CM structure and conventions - Principal diagnosis selection - Code accuracy and specificity - Chapter-specific guidelines - Secondary diagnosis coding
Topic 2: Billing Compliance and Regulations	10-15%	- Documentation compliance - Stark Law and Anti-Kickback Statute basics - Appeal and denial management - HIPAA privacy and security requirements - Fraud, waste, and abuse prevention
Topic 3: Practice Management	10-15%	- Patient registration and demographics - Insurance verification processes - Patient responsibility calculations - Collections and payment posting - Accounts receivable management
Topic 4: CPT Coding	20-25%	- Evaluation and Management (E/M) codes - Category II and III codes - Modifiers and their appropriate use - Surgical procedure codes - CPT code categories and structure
Topic 5: Healthcare Billing Fundamentals	15-20%	- Anatomy and physiology for billers - Medical terminology basics - Healthcare documentation principles - Revenue cycle overview
Topic 6: Insurance and Reimbursement	20-25%	- Commercial insurance policies - Government payers (Medicare, Medicaid, TRICARE) - Workers' compensation and no-fault billing - Claims submission and processing - Fee schedules and reimbursement methodologies - Coordination of benefits

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AAPC Certified Professional Biller (CPB) Sample Questions (Q65-Q70):

NEW QUESTION # 65
What does it mean by gyn, gyne and gynec?

A. women, female
B. men, male

Answer: A

NEW QUESTION # 66
Which professional association was founded to improve the quality of medical records and current advances toward an electronic and global environment including the implementation of ICD10CM

A. An association of independent Blue Cross Blue Shield plans
B. Joint venture between Blue Cross and Blue shield where the corporations shared one building and computer services but maintained separate corporate identities
C. American Health Information Management Association (AHIMA)
D. American Academy of Professional Coders (AAPC)

Answer: C

NEW QUESTION # 67
Current Procedural Terminology (CPT) is used to report professional services to payers.

A. TRUE
B. FALSE

Answer: A

NEW QUESTION # 68
EGHP

A. Evaluation and Management
B. Electronic Health Record
C. Electronic Healthcare Network Accreditation Commission
D. Employer group health plan

Answer: D

NEW QUESTION # 69
What is the primary purpose of National Correct Coding Initiative (NCCI) edits?

A. Increase claim approvals
B. Identify unbundling and improper coding
C. Set reimbursement rates
D. Replace CPT guidelines

Answer: B

Explanation:
NCCI edits prevent unbundling and inappropriate coding combinations.

NEW QUESTION # 70
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