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| Section | Weight | Objectives |
|---|
| ICD-10-CM Diagnosis Coding | 15-20% | - Code accuracy and specificity - Secondary diagnosis coding - Chapter-specific guidelines - ICD-10-CM structure and conventions - Principal diagnosis selection
|
| Practice Management | 10-15% | - Collections and payment posting - Patient registration and demographics - Accounts receivable management - Insurance verification processes - Patient responsibility calculations
|
| Billing Compliance and Regulations | 10-15% | - Documentation compliance - Fraud, waste, and abuse prevention - Appeal and denial management - Stark Law and Anti-Kickback Statute basics - HIPAA privacy and security requirements
|
| Healthcare Billing Fundamentals | 15-20% | - Revenue cycle overview - Healthcare documentation principles - Medical terminology basics - Anatomy and physiology for billers
|
| Insurance and Reimbursement | 20-25% | - Coordination of benefits - Workers' compensation and no-fault billing - Fee schedules and reimbursement methodologies - Government payers (Medicare, Medicaid, TRICARE) - Claims submission and processing - Commercial insurance policies
|
| CPT Coding | 20-25% | - Modifiers and their appropriate use - Surgical procedure codes - Category II and III codes - Evaluation and Management (E/M) codes - CPT code categories and structure
|
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AAPC - CPB - Certified Professional Biller (CPB) High Hit-Rate Valid Test Duration
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AAPC Certified Professional Biller (CPB) Sample Questions (Q191-Q196):
NEW QUESTION # 191
Who is a person who performs services for another under an expressed or implied agreement?
- A. Health Insurance Specialist
- B. Independent Contractor
- C. Healthcare Provider
Answer: B
NEW QUESTION # 192
What does AHFS stand for?
- A. American Healthcare Formulary Service
- B. American Hospital Formulary Service
- C. American Healthcare Formulary Standards
- D. American Hospital Formulary Standards
Answer: B
NEW QUESTION # 193
What does it mean by erythr?
- A. red
- B. blue
- C. yellow
- D. green
Answer: A
NEW QUESTION # 194
EDI
- A. Electronic data interchange
- B. Electronic Healthcare Network Accreditation Commission
- C. Electronic funds transfer
- D. Employer group health plan
Answer: A
NEW QUESTION # 195
The medical prefix "ab-" means:
- A. extremities, top
- B. abdomen
- C. toward
- D. away from
Answer: D
NEW QUESTION # 196
......
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