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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q74-Q79):

NEW QUESTION # 74
BCBS stands for Blue Cross Blue Shield.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 75
The word root "acr" (or "acro-") refers to:

A. extremities, top
B. fat
C. toward

Answer: A

NEW QUESTION # 76
Preauthorization is an authorization that must be received from a payer before treatment by a specialist will be covered.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 77
FECA stands for Federal Employment Compensation Act.

A. FALSE
B. TRUE

Answer: B

NEW QUESTION # 78
What are black box edits?

A. Published code edits, which were discontinued in 2000.
B. Published code edits, which were discontinued in 2001.
C. Nonpublished code edits, which were discontinued in 2001.
D. Nonpublished code edits, which were discontinued in 2000.

Answer: D

NEW QUESTION # 79
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