PDF Version DemoAAPC AAPC Certification CPB Certified Professional Biller (CPB) Exams
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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| CPT Coding | 20-25% | - Modifiers and their appropriate use - Evaluation and Management (E/M) codes - CPT code categories and structure - Category II and III codes - Surgical procedure codes |
| Practice Management | 10-15% | - Patient responsibility calculations - Collections and payment posting - Patient registration and demographics - Insurance verification processes - Accounts receivable management |
| Healthcare Billing Fundamentals | 15-20% | - Healthcare documentation principles - Medical terminology basics - Revenue cycle overview - Anatomy and physiology for billers |
| ICD-10-CM Diagnosis Coding | 15-20% | - ICD-10-CM structure and conventions - Code accuracy and specificity - Principal diagnosis selection - Secondary diagnosis coding - Chapter-specific guidelines |
| Insurance and Reimbursement | 20-25% | - Workers' compensation and no-fault billing - Claims submission and processing - Fee schedules and reimbursement methodologies - Coordination of benefits - Government payers (Medicare, Medicaid, TRICARE) - Commercial insurance policies |
| Billing Compliance and Regulations | 10-15% | - Fraud, waste, and abuse prevention - HIPAA privacy and security requirements - Stark Law and Anti-Kickback Statute basics - Documentation compliance - Appeal and denial management |
AAPC Certified Professional Biller (CPB) Sample Questions:
Question #1
Which factor determines the correct payer sequence in coordination of benefits (COB)?
A. Birthday rule
B. Provider type
C. Patient preference
D. Length of employment
Question #2
What is the primary purpose of National Correct Coding Initiative (NCCI) edits?
A. Set reimbursement rates
B. Replace CPT guidelines
C. Identify unbundling and improper coding
D. Increase claim approvals
Question #3
What does ANSI stand for?
A. American National Services Institute
B. American National Standards Institute
C. American National Services Information
D. American National Standards Information
Question #4
What does the acronym FSA stand for?
A. General Enrollment Period
B. Flexible Spending Account
C. Geographic Cost Practice Index
D. General Equivalency Mapping
Question #5
What does AHFS stand for?
A. American Healthcare Formulary Standards
B. American Hospital Formulary Service
C. American Healthcare Formulary Service
D. American Hospital Formulary Standards
Solutions:
| Question #1 Correct Answer: A | Question #2 Correct Answer: C | Question #3 Correct Answer: B | Question #4 Correct Answer: B | Question #5 Correct Answer: B |
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