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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q233-Q238):

NEW QUESTION # 233
Blue Cross Blue Shield (BCBS) is joint venture between Blue Cross and Blue Shield where the corporation shared one building and computer.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 234
The medical prefix "hyper-" means:

A. uterus, womb
B. above, excessive
C. condition

Answer: B

NEW QUESTION # 235
What are Category I Codes?

A. Temporary codes for data collection purposes that are assigned an alphanumeric identifier with a letter in the last field (e.g., 0001T) these codes are located after the Medicine section, and will be archived after five years unless accepted for placement within Category I sections of CPT.
B. Procedures/ services identified by a five digit CPT code and descriptor nomenclature; these codes are traditionally associated with CPT and organized within six sections.
C. Optional performance measurement tracking codes that are assigned an alphanumeric identifier with a letter in the last field (e,g.,1234A); these codes will be located after the medicine section; their use is optional.

Answer: B

NEW QUESTION # 236
What is the coding system currently in use to report diagnoses and reasons for encounter?

A. International Classification of Diseases, 7th revision, clinical modification (ICD7CM)
B. International Classification of Diseases, 8th revision, clinical modification (ICD8CM)
C. International Classification of Diseases, 9th revision, clinical modification (ICD9CM)
D. International Classification of Diseases, 6th revision, clinical modification (ICD6CM)

Answer: C

NEW QUESTION # 237
The medical word root "ankyl/o" (or "ankyl") means:

A. joint
B. against
C. condition
D. crooked, bent

Answer: D

NEW QUESTION # 238
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