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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Coding Concepts for Billers | 12% | - ICD-10-CM, CPT®, HCPCS Level II - Medical necessity - Code validation, modifiers |
| Topic 2: HIPAA and Compliance | 9% | - Compliance programs - Privacy, security, transaction standards - Medical record retention - Fraud, abuse, False Claims Act |
| Topic 3: Claims and Billing | 14% | - Electronic claims, clearinghouses - Timely filing rules - Denials, appeals, corrections - Claim submission, tracking, follow-up |
| Topic 4: Case Analysis | 17% | - Eligibility verification - Adjudication and resolution - End-to-end billing scenarios |
| Topic 5: Reimbursement and Collections | 14% | - Accounts receivable management - Payment posting, adjustments - Refunds, payment plans, write-offs - Patient statements, collections |
| Topic 6: Billing Regulations | 13% | - Payer payment policies - ACOs, NCCI, LCDs, NCDs - Incident-to billing, global packages - CMS-1500, UB-04 completion |
| Topic 7: Types of Insurance | 21% | - Medicare, Medigap, Medicaid - Third-party liability - Commercial payers - TRICARE/CHAMPUS, Workers' compensation - Managed care plans |
The web-based AAPC CPB practice exam is compatible with all browsers like Chrome, Mozilla Firefox, MS Edge, Internet Explorer, Safari, Opera, and more. Unlike the desktop version, it requires an internet connection. The Certified Professional Biller (CPB) (CPB) practice exam will ask real Certified Professional Biller (CPB) (CPB) exam questions. Consistent practice with it relieves exam stress and boosts self-confidence. The web-based Certified Professional Biller (CPB) (CPB) practice exam does not require additional software installation. All operating systems also support this Certified Professional Biller (CPB) (CPB) practice test.
NEW QUESTION # 238
ERA
Answer: A
NEW QUESTION # 239
What is the amount owed to a business for services or goods provided?
Answer: B
NEW QUESTION # 240
What is the main purpose of an audit in medical billing?
Answer: D
Explanation:
Audits are used to verify accurate billing practices and ensure compliance with regulations.
NEW QUESTION # 241
What does the acronym E/M stand for in medical coding?
Answer: D
NEW QUESTION # 242
Allowable Charge
Answer: A
NEW QUESTION # 243
......
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