2026 CPB: Certified Professional Biller (CPB)–Accurate Exam Questions Vce

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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q50-Q55):

NEW QUESTION # 50
ilio

Answer: D


NEW QUESTION # 51
What should be done if an insurance company incorrectly denies a covered service?

Answer: B

Explanation:
Appeals require corrected information and documentation to support payment.


NEW QUESTION # 52
What does it mean by juxta?

Answer: A


NEW QUESTION # 53
ASC (Choose two.)

Answer: A,D


NEW QUESTION # 54
Which scenario would most likely result in a claim denial for lack of medical necessity?

Answer: A

Explanation:
Medical necessity denials occur when the diagnosis does not justify the billed service.


NEW QUESTION # 55
......

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