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AAPC CPB Exam Syllabus Topics:

Section	Objectives
Topic 1: Coding and Claim Submission Basics	- Claims submission processes - ICD-10-CM, CPT, and HCPCS overview - Use of modifiers and coding compliance
Topic 2: Revenue Cycle Management	- Claims denial and rejection management - Accounts receivable follow-up - Payment posting and reconciliation
Topic 3: Compliance and Regulations	- Billing compliance standards - Fraud and abuse prevention - HIPAA and patient privacy rules
Topic 4: Medical Billing Fundamentals	- Medical billing workflow and revenue cycle - Insurance types and payer structures - Healthcare reimbursement systems
Topic 5: Insurance Processing and Payer Rules	- Private insurance policies and contracts - Medicare and Medicaid guidelines - Coordination of benefits (COB)

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AAPC Certified Professional Biller (CPB) Sample Questions (Q215-Q220):

NEW QUESTION # 215
What should be done if an insurance company incorrectly denies a covered service?

A. Bill the patient immediately
B. Write off the charge
C. File an appeal with supporting documentation
D. Resubmit the same claim without changes

Answer: C

Explanation:
Appeals require corrected information and documentation to support payment.

NEW QUESTION # 216
What does it mean by gluc and glyc?

A. protein
B. vitamins
C. fat
D. sugar, glucose

Answer: D

NEW QUESTION # 217
Which situation is considered billing fraud?

A. Typographical error on a claim
B. Appealing a denied claim
C. Late claim submission
D. Billing for services not rendered

Answer: D

Explanation:
Billing for services not provided is considered fraudulent activity.

NEW QUESTION # 218
What is accreditation?

A. Voluntary Process that a healthcare facility or organization (e.g. hospital or managed care plan) undergoes to demonstrate that it has met standards beyond those required by law.
B. Involuntary Process that a healthcare facility or organization (e.g. hospital or managed care plan) undergoes to demonstrate that it has met standards beyond those required by law.

Answer: A

NEW QUESTION # 219
What is the coding system currently in use to report diagnoses and reasons for encounter?

A. International Classification of Diseases, 9th revision, clinical modification (ICD9CM)
B. International Classification of Diseases, 6th revision, clinical modification (ICD6CM)
C. International Classification of Diseases, 8th revision, clinical modification (ICD8CM)
D. International Classification of Diseases, 7th revision, clinical modification (ICD7CM)

Answer: A

NEW QUESTION # 220
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