CPB - Certified Professional Biller (CPB)–High-quality Exam Passing Score

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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q151-Q156):

NEW QUESTION # 151
Blue Shield (BS) __________

A. began as a resolution passed by the house of Delegates at an American Medical Association meetings in 1941; incorporates a concept of voluntary health insurance that encourages physicians to corporate with prepaid health plans.
B. began as a resolution passed by the house of Delegates at an American Medical Association meetings in 1938; incorporates a concept of voluntary health insurance that encourages physicians to corporate with prepaid health plans.
C. began as a resolution passed by the house of Delegates at an American Medical Association meetings in 1939; incorporates a concept of voluntary health insurance that encourages physicians to corporate with prepaid health plans.
D. began as a resolution passed by the house of Delegates at an American Medical Association meetings in 1940; incorporates a concept of voluntary health insurance that encourages physicians to corporate with prepaid health plans.

Answer: B

NEW QUESTION # 152
Which factor determines the correct payer sequence in coordination of benefits (COB)?

A. Patient preference
B. Birthday rule
C. Provider type
D. Length of employment

Answer: B

Explanation:
The birthday rule is used for dependents to determine primary coverage.

NEW QUESTION # 153
FECA stands for Federal Employment Compensation Act.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 154
Which of the following suffixes does NOT mean blood?

A. hemat
B. hema
C. hem
D. dacry

Answer: D

NEW QUESTION # 155
Case manager submits written confirmation, authorizing treatment, to provider.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 156
......

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