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AAPC CPB Exam Syllabus Topics:

Section	Weight	Objectives
Topic 1: Practice Management	10-15%	- Accounts receivable management - Collections and payment posting - Patient responsibility calculations - Insurance verification processes - Patient registration and demographics
Topic 2: ICD-10-CM Diagnosis Coding	15-20%	- Principal diagnosis selection - Chapter-specific guidelines - Secondary diagnosis coding - ICD-10-CM structure and conventions - Code accuracy and specificity
Topic 3: CPT Coding	20-25%	- Modifiers and their appropriate use - Category II and III codes - CPT code categories and structure - Surgical procedure codes - Evaluation and Management (E/M) codes
Topic 4: Insurance and Reimbursement	20-25%	- Claims submission and processing - Coordination of benefits - Government payers (Medicare, Medicaid, TRICARE) - Commercial insurance policies - Workers' compensation and no-fault billing - Fee schedules and reimbursement methodologies
Topic 5: Healthcare Billing Fundamentals	15-20%	- Revenue cycle overview - Anatomy and physiology for billers - Healthcare documentation principles - Medical terminology basics
Topic 6: Billing Compliance and Regulations	10-15%	- Stark Law and Anti-Kickback Statute basics - HIPAA privacy and security requirements - Appeal and denial management - Documentation compliance - Fraud, waste, and abuse prevention

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AAPC Certified Professional Biller (CPB) Sample Questions (Q29-Q34):

NEW QUESTION # 29
Which part of the body does cervic refer to?

A. head
B. neck
C. skull
D. vagina

Answer: B

NEW QUESTION # 30
American Academy of Processional Coders (AAPC) is professional association established to provide a national certification and credentialing process, to support the national and local membership by providing educational products and opportunities to network, and to increase and promote national recognition and awareness of professional coding.

A. TRUE
B. FALSE

Answer: A

NEW QUESTION # 31
CDAC stands for Clinical Data Abstracting Center.

A. TRUE
B. FALSE

Answer: A

NEW QUESTION # 32
What is Blue Cross (BC)?

A. Insurance plan created in 1929 when Baylor University Hospital, in Dallas, TX, approached teachers in Dallas school district with a plan that guaranteed up to 20 days of hospitalization per year for subscribers and each dependent for a $6 annual premium.
B. Insurance plan created in 1930 when Baylor University Hospital, in Dallas, TX, approached teachers in Dallas school district with a plan that guaranteed up to 20 days of hospitalization per year for subscribers and each dependent for a $6 annual premium.
C. Insurance plan created in 1929 when Baylor University Hospital, in Dallas, TX, approached teachers in Dallas school district with a plan that guaranteed up to 21 days of hospitalization per year for subscribers and each dependent for a $6 annual premium.
D. Insurance plan created in 1930 when Baylor University Hospital, in Dallas, TX, approached teachers in Dallas school district with a plan that guaranteed up to 21 days of hospitalization per year for subscribers and each dependent for a $6 annual premium.

Answer: C

NEW QUESTION # 33
Which term refers to a digital version of a patient's paper chart, encompassing a comprehensive record of patient health information?

A. Early and Periodic screening, diagnostic, and treatment
B. Explanation of Benefits
C. Exclusive provider organization
D. Electronic Medical Record

Answer: D

NEW QUESTION # 34
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