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AAPC CPB Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Practice Management10-15%- Insurance verification processes
- Accounts receivable management
- Patient registration and demographics
- Patient responsibility calculations
- Collections and payment posting
Topic 2: ICD-10-CM Diagnosis Coding15-20%- Code accuracy and specificity
- ICD-10-CM structure and conventions
- Principal diagnosis selection
- Chapter-specific guidelines
- Secondary diagnosis coding
Topic 3: Healthcare Billing Fundamentals15-20%- Revenue cycle overview
- Anatomy and physiology for billers
- Medical terminology basics
- Healthcare documentation principles
Topic 4: CPT Coding20-25%- Category II and III codes
- Modifiers and their appropriate use
- CPT code categories and structure
- Surgical procedure codes
- Evaluation and Management (E/M) codes
Topic 5: Insurance and Reimbursement20-25%- Fee schedules and reimbursement methodologies
- Government payers (Medicare, Medicaid, TRICARE)
- Commercial insurance policies
- Claims submission and processing
- Workers' compensation and no-fault billing
- Coordination of benefits
Topic 6: Billing Compliance and Regulations10-15%- Appeal and denial management
- Documentation compliance
- Fraud, waste, and abuse prevention
- Stark Law and Anti-Kickback Statute basics
- HIPAA privacy and security requirements

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AAPC Certified Professional Biller (CPB) Sample Questions (Q43-Q48):

NEW QUESTION # 43
EDI

Answer: A


NEW QUESTION # 44
What does the acronym FR stand for?

Answer: D


NEW QUESTION # 45
What does it mean by cyan?

Answer: A


NEW QUESTION # 46
Advance Beneficiary Notice (ABN) is document that acknowledges patient responsibility for payment if Medicare denies the claim.

Answer: B


NEW QUESTION # 47
Preauthorization is an authorization that must be received from a payer before treatment by a specialist will be covered.

Answer: B


NEW QUESTION # 48
......

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