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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q20-Q25):

NEW QUESTION # 20
Which part of the body does genit refer to?

Answer: C


NEW QUESTION # 21
CMP

Answer: C


NEW QUESTION # 22
HICN stands for Health Insurance claim number.

Answer: B


NEW QUESTION # 23
Which amount is written off when a provider is contracted with an insurance company?

Answer: A

Explanation:
Contractual adjustments are the differences between billed charges and allowed amounts.


NEW QUESTION # 24
What does CF stand for?

Answer: C


NEW QUESTION # 25
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