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AAPC CPB Exam Syllabus Topics:

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

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

NEW QUESTION # 237
What does the acronym CT stand for?

Answer: A


NEW QUESTION # 238
What does it mean by graph?

Answer: C


NEW QUESTION # 239
What does AHIMA stand for?

Answer: C


NEW QUESTION # 240
COB

Answer: C


NEW QUESTION # 241
Adverse Selection includes covering members who are sicker then the general population.

Answer: B


NEW QUESTION # 242
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