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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q113-Q118):

NEW QUESTION # 113
Which is the universal claim form used by physicians offices?

Answer: C


NEW QUESTION # 114
Ambulance Fee Schedule is payment system for ambulance services provided to Medicare Beneficiaries.

Answer: B


NEW QUESTION # 115
What does it mean by dacry?

Answer: C


NEW QUESTION # 116
Billing entity is the legal business name of the provider's practice.

Answer: B


NEW QUESTION # 117
The medical word root "ileo" refers to the:

Answer: D


NEW QUESTION # 118
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