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AAPC CPB Exam Syllabus Topics:

Section	Weight	Objectives
Insurance and Reimbursement	20-25%	- Claims submission and processing - Coordination of benefits - Workers' compensation and no-fault billing - Fee schedules and reimbursement methodologies - Commercial insurance policies - Government payers (Medicare, Medicaid, TRICARE)
Practice Management	10-15%	- Patient responsibility calculations - Accounts receivable management - Patient registration and demographics - Insurance verification processes - Collections and payment posting
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 - Secondary diagnosis coding - Code accuracy and specificity - ICD-10-CM structure and conventions - Principal diagnosis selection
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
Billing Compliance and Regulations	10-15%	- Fraud, waste, and abuse prevention - Appeal and denial management - HIPAA privacy and security requirements - Documentation compliance - Stark Law and Anti-Kickback Statute basics

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AAPC Certified Professional Biller (CPB) Sample Questions (Q35-Q40):

NEW QUESTION # 35
BCBSA stands for Blue Cross Blue Shield Association.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 36
What does CCS stand for?

A. Certified Coding Specialist
B. Certified Coding Services
C. Certified Coding Standards

Answer: A

NEW QUESTION # 37
American Association of Medical Assistants (AAMA) enables medical assisting professionals to enhance and demonstrate the knowledge, skills, and professionalism required by employers and patients; as well as protect medical assistants' right to practice.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 38
What does AMA stand for?

A. American Management Association
B. American Medical Association
C. American Military Association

Answer: B

NEW QUESTION # 39
Accounts Receivable Aging Report

A. Shows the status (by date) of outstanding claims from each payer, as well as payments due from patients.
B. Judicial dispute resolution process in which an appeals board makes a final determination.
C. Assists Providers in the collection of appropriate reimbursement for services rendered; include functions such as insurance verification/eligibility and preauthorization of services.
D. Voluntary Process that a healthcare facility or organization (e.g. hospital or managed care plan) undergoes to demonstrate that it has met standards beyond those required by law.

Answer: A

NEW QUESTION # 40
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