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AAPC CPB Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Insurance and Reimbursement20-25%- Workers' compensation and no-fault billing
- Coordination of benefits
- Government payers (Medicare, Medicaid, TRICARE)
- Commercial insurance policies
- Fee schedules and reimbursement methodologies
- Claims submission and processing
Topic 2: Practice Management10-15%- Patient responsibility calculations
- Accounts receivable management
- Collections and payment posting
- Patient registration and demographics
- Insurance verification processes
Topic 3: Billing Compliance and Regulations10-15%- Stark Law and Anti-Kickback Statute basics
- Documentation compliance
- Appeal and denial management
- Fraud, waste, and abuse prevention
- HIPAA privacy and security requirements
Topic 4: CPT Coding20-25%- Evaluation and Management (E/M) codes
- CPT code categories and structure
- Surgical procedure codes
- Modifiers and their appropriate use
- Category II and III codes
Topic 5: Healthcare Billing Fundamentals15-20%- Healthcare documentation principles
- Revenue cycle overview
- Anatomy and physiology for billers
- Medical terminology basics
Topic 6: ICD-10-CM Diagnosis Coding15-20%- Principal diagnosis selection
- ICD-10-CM structure and conventions
- Chapter-specific guidelines
- Secondary diagnosis coding
- Code accuracy and specificity

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AAPC Certified Professional Biller (CPB) Sample Questions (Q155-Q160):

NEW QUESTION # 155
What does it mean by brachy?

Answer: B


NEW QUESTION # 156
What is the provider's responsibility when a patient has a copayment?

Answer: B

Explanation:
Copayments are patient responsibility and should be collected at the time of service.


NEW QUESTION # 157
What does AHIMA stand for?

Answer: D


NEW QUESTION # 158
HSA stands for Health Savings account.

Answer: A


NEW QUESTION # 159
contra

Answer: B


NEW QUESTION # 160
......

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