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AAPC CPB Exam Syllabus Topics:

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

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AAPC CPB Exam Price | Exam CPB Questions Answers

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AAPC Certified Professional Biller (CPB) Sample Questions (Q180-Q185):

NEW QUESTION # 180
Which is the universal claim form used by physicians offices?

A. Centers of Medicare and Medicaid Services150 (CMS1500)
B. Explanation of Benefits
C. Health Insurance Claim
D. Hold Harmless Clause

Answer: A

NEW QUESTION # 181
Blue Shield (BS) __________

A. 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.
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 1940; 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 1941; incorporates a concept of voluntary health insurance that encourages physicians to corporate with prepaid health plans.

Answer: B

NEW QUESTION # 182
CMS1500

A. Insurance claim used by noninstitutional providers and supplier to bill payers
B. Clinical nurse specialist
C. Coordination of Benefits
D. Consolidated Omnibus Budget Reconciliation Act of 1985

Answer: A

NEW QUESTION # 183
FDCPA

A. Federal Employment Liability Act
B. Federal Employee Health Benefit Program
C. Fair Debt Collection Practices Act
D. Federal Employment Compensation Act

Answer: C

NEW QUESTION # 184
CA refers to Cancer or Carcinoma.

A. TRUE
B. FALSE

Answer: A

NEW QUESTION # 185
......

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