Free PDF CPB - Fantastic Detail Certified Professional Biller (CPB) Explanation

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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q22-Q27):

NEW QUESTION # 22
What does it mean by itis?

Answer: C


NEW QUESTION # 23
The medical prefix "dys-" means:

Answer: A


NEW QUESTION # 24
Birthday rule determines coverage by primary and secondary policies when each parent subscribes to a different health insurance plan.

Answer: B


NEW QUESTION # 25
DME

Answer: D


NEW QUESTION # 26
Which document communicates to the payer that the provider is requesting reimbursement?

Answer: A


NEW QUESTION # 27
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