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AAPC CPB Exam Syllabus Topics:

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

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AAPC Certified Professional Biller (CPB) Sample Questions (Q214-Q219):

NEW QUESTION # 214
Which scenario would most likely result in a claim denial for lack of medical necessity?

Answer: B

Explanation:
Medical necessity denials occur when the diagnosis does not justify the billed service.


NEW QUESTION # 215
What does AHA stand for?

Answer: D


NEW QUESTION # 216
What does it mean by benign?

Answer: B


NEW QUESTION # 217
ASC (Choose two.)

Answer: B,C


NEW QUESTION # 218
EGHP

Answer: D


NEW QUESTION # 219
......

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