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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q46-Q51):

NEW QUESTION # 46
Which part of the body does cervic refer to?

Answer: B


NEW QUESTION # 47
CSCP

Answer: D


NEW QUESTION # 48
COBRA

Answer: D


NEW QUESTION # 49
Who is the person who prepares and reviews claims for accuracy to ensure prompt payment?

Answer: C


NEW QUESTION # 50
Cafeteria plan is also called triple option plan; provides different health benefits plans and extra coverage options through an insure or third-party administrator.

Answer: A


NEW QUESTION # 51
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