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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q47-Q52):

NEW QUESTION # 47
What document is used to transfer patient financial responsibility after insurance adjudication?

Answer: D

Explanation:
A patient statement reflects remaining balances after insurance processing.


NEW QUESTION # 48
What are Category III codes?

Answer: B


NEW QUESTION # 49
ad

Answer: A


NEW QUESTION # 50
Which part of the body does crani refer to?

Answer: C


NEW QUESTION # 51
iasis

Answer: D


NEW QUESTION # 52
......

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