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AAPC CPB Exam Syllabus Topics:

SectionWeightObjectives
HIPAA and Compliance9%- Fraud, abuse, False Claims Act
- Privacy, security, transaction standards
- Medical record retention
- Compliance programs
Reimbursement and Collections14%- Refunds, payment plans, write-offs
- Accounts receivable management
- Payment posting, adjustments
- Patient statements, collections
Claims and Billing14%- Claim submission, tracking, follow-up
- Electronic claims, clearinghouses
- Denials, appeals, corrections
- Timely filing rules
Types of Insurance21%- Third-party liability
- TRICARE/CHAMPUS, Workers' compensation
- Medicare, Medigap, Medicaid
- Managed care plans
- Commercial payers
Case Analysis17%- End-to-end billing scenarios
- Eligibility verification
- Adjudication and resolution
Coding Concepts for Billers12%- Medical necessity
- Code validation, modifiers
- ICD-10-CM, CPT®, HCPCS Level II
Billing Regulations13%- CMS-1500, UB-04 completion
- Payer payment policies
- ACOs, NCCI, LCDs, NCDs
- Incident-to billing, global packages

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AAPC Certified Professional Biller (CPB) Sample Questions (Q64-Q69):

NEW QUESTION # 64
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.

Answer: B


NEW QUESTION # 65
FELA stands for Federal Employment Liability Act.

Answer: B


NEW QUESTION # 66
The medical prefixes "hypo-" or "hyp-" mean:

Answer: B


NEW QUESTION # 67
DME

Answer: A


NEW QUESTION # 68
Which part of the body does cervic refer to?

Answer: D


NEW QUESTION # 69
......

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