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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q237-Q242):

NEW QUESTION # 237
Catchment area is the region defined by code boundaries within a 40mile radius of a military treatment facility.

Answer: A


NEW QUESTION # 238
DMEPOS

Answer: A


NEW QUESTION # 239
HCRA stands for Healthcare Reimbursement Account.

Answer: A


NEW QUESTION # 240
Carcinoma (Ca) in situ is a malignant tumor that is localized, circumscribed, encapsulated, and noninvasive (has not spread to deeper or adjacent tissues or organs).

Answer: A


NEW QUESTION # 241
ERA

Answer: D


NEW QUESTION # 242
......

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