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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Billing Compliance and Regulations | 10-15% | - Fraud, waste, and abuse prevention - Stark Law and Anti-Kickback Statute basics - Documentation compliance - Appeal and denial management - HIPAA privacy and security requirements |
| Topic 2: CPT Coding | 20-25% | - Modifiers and their appropriate use - Surgical procedure codes - Category II and III codes - CPT code categories and structure - Evaluation and Management (E/M) codes |
| Topic 3: Healthcare Billing Fundamentals | 15-20% | - Medical terminology basics - Healthcare documentation principles - Anatomy and physiology for billers - Revenue cycle overview |
| Topic 4: Insurance and Reimbursement | 20-25% | - Commercial insurance policies - Coordination of benefits - Fee schedules and reimbursement methodologies - Workers' compensation and no-fault billing - Government payers (Medicare, Medicaid, TRICARE) - Claims submission and processing |
| Topic 5: ICD-10-CM Diagnosis Coding | 15-20% | - ICD-10-CM structure and conventions - Chapter-specific guidelines - Code accuracy and specificity - Secondary diagnosis coding - Principal diagnosis selection |
| Topic 6: Practice Management | 10-15% | - Patient responsibility calculations - Collections and payment posting - Insurance verification processes - Accounts receivable management - Patient registration and demographics |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. BCBS stands for Blue Cross Blue Shield.
A) TRUE
B) FALSE
2. ad
A) pertaining to
B) fat
C) toward
3. What does the acronym FR stand for?
A) Federal Register
B) General Enrollment Period
C) General Equivalency Mapping
D) Flexible Spending Account
4. Case management services is a process by which an attending physician coordinates and supervises care provided to patient by other providers.
A) TRUE
B) FALSE
5. Which of the following suffixes refers to in?
A) ex
B) extra
C) en
D) red
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: C | Question # 3 Answer: A | Question # 4 Answer: A | Question # 5 Answer: C |
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Albert 
Adam 
Belinda 
Novia 
Yvette 
Maria 
Alva 
Tammy 
Hale 
Martina 
Yale 
Horace 
Vic 
Christine 
Richard 
Kenneth 
Marvin 
Alice 
Frederica 
