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| Section | Weight | Objectives |
|---|
| CPT Coding | 20-25% | - Evaluation and Management (E/M) codes - CPT code categories and structure - Surgical procedure codes - Category II and III codes - Modifiers and their appropriate use
|
| ICD-10-CM Diagnosis Coding | 15-20% | - Chapter-specific guidelines - Secondary diagnosis coding - Code accuracy and specificity - ICD-10-CM structure and conventions - Principal diagnosis selection
|
| Insurance and Reimbursement | 20-25% | - Fee schedules and reimbursement methodologies - Government payers (Medicare, Medicaid, TRICARE) - Claims submission and processing - Workers' compensation and no-fault billing - Coordination of benefits - Commercial insurance policies
|
| Practice Management | 10-15% | - Patient responsibility calculations - Accounts receivable management - Collections and payment posting - Insurance verification processes - Patient registration and demographics
|
| Billing Compliance and Regulations | 10-15% | - Documentation compliance - Appeal and denial management - Stark Law and Anti-Kickback Statute basics - Fraud, waste, and abuse prevention - HIPAA privacy and security requirements
|
| Healthcare Billing Fundamentals | 15-20% | - Anatomy and physiology for billers - Revenue cycle overview - Medical terminology basics - Healthcare documentation principles
|
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AAPC Certified Professional Biller (CPB) Sample Questions (Q82-Q87):
NEW QUESTION # 82
Which document is mailed by the payer to the patient to illustrate the reimbrsement amount of a covered benefit?
- A. Hold Harmless Clause
- B. Centers of Medicare and Medicaid Services150 (CMS1500)
- C. Health Insurance Claim
- D. Explanation of Benefits
Answer: D
NEW QUESTION # 83
What does BS stand for?
- A. Beneficiary Services
- B. Black Shield
- C. Blue Shield
- D. Beneficiary Standards
Answer: C
NEW QUESTION # 84
The medical word root "eti" (or "eti/o") refers to:
- A. cause
- B. outside
- C. fiber
- D. out, away from
Answer: A
NEW QUESTION # 85
What does it mean by dextr?
Answer: A
NEW QUESTION # 86
What does CDT stand for?
- A. Civilian Dental Terminology
- B. Current Dental Terminology
- C. Comprehensive Dental Terminology
- D. Conversion Dental Terminology
Answer: B
NEW QUESTION # 87
......
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