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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q84-Q89):

NEW QUESTION # 84
CNS

Answer: A


NEW QUESTION # 85
Which factor determines the correct payer sequence in coordination of benefits (COB)?

Answer: B

Explanation:
The birthday rule is used for dependents to determine primary coverage.


NEW QUESTION # 86
What does APC stand for?

Answer: D


NEW QUESTION # 87
The medical prefix "ab-" means:

Answer: B


NEW QUESTION # 88
Cafeteria plan is also called triple option plan; provides different health benefits plans and extra coverage options through an insure or third-party administrator.

Answer: A


NEW QUESTION # 89
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