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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q158-Q163):

NEW QUESTION # 158
Which part of the body do colp and kolp refer to?

Answer: B


NEW QUESTION # 159
CPT

Answer: D


NEW QUESTION # 160
What does HA stand for?

Answer: B


NEW QUESTION # 161
contra

Answer: B


NEW QUESTION # 162
HICN stands for Health Insurance claim number.

Answer: B


NEW QUESTION # 163
......

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