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AAPC CPB Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Practice Management10-15%- Patient responsibility calculations
- Collections and payment posting
- Patient registration and demographics
- Insurance verification processes
- Accounts receivable management
Topic 2: Healthcare Billing Fundamentals15-20%- Medical terminology basics
- Revenue cycle overview
- Healthcare documentation principles
- Anatomy and physiology for billers
Topic 3: Billing Compliance and Regulations10-15%- Appeal and denial management
- HIPAA privacy and security requirements
- Fraud, waste, and abuse prevention
- Documentation compliance
- Stark Law and Anti-Kickback Statute basics
Topic 4: ICD-10-CM Diagnosis Coding15-20%- Secondary diagnosis coding
- Principal diagnosis selection
- Chapter-specific guidelines
- ICD-10-CM structure and conventions
- Code accuracy and specificity
Topic 5: Insurance and Reimbursement20-25%- Claims submission and processing
- Fee schedules and reimbursement methodologies
- Government payers (Medicare, Medicaid, TRICARE)
- Coordination of benefits
- Workers' compensation and no-fault billing
- Commercial insurance policies
Topic 6: CPT Coding20-25%- Category II and III codes
- Modifiers and their appropriate use
- CPT code categories and structure
- Evaluation and Management (E/M) codes
- Surgical procedure codes

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AAPC Certified Professional Biller (CPB) Sample Questions (Q99-Q104):

NEW QUESTION # 99
iasis

Answer: B


NEW QUESTION # 100
What are actions inconsistent with accepted, sound medical business or fiscal practice?

Answer: C


NEW QUESTION # 101
hemi

Answer: D


NEW QUESTION # 102
What does APC stand for?

Answer: A


NEW QUESTION # 103
Accounts Receivable Management

Answer: A


NEW QUESTION # 104
......

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