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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Insurance and Reimbursement | 20-25% | - Workers' compensation and no-fault billing - Coordination of benefits - Fee schedules and reimbursement methodologies - Government payers (Medicare, Medicaid, TRICARE) - Commercial insurance policies - Claims submission and processing |
| Billing Compliance and Regulations | 10-15% | - Appeal and denial management - Fraud, waste, and abuse prevention - Documentation compliance - HIPAA privacy and security requirements - Stark Law and Anti-Kickback Statute basics |
| ICD-10-CM Diagnosis Coding | 15-20% | - Chapter-specific guidelines - Principal diagnosis selection - ICD-10-CM structure and conventions - Code accuracy and specificity - Secondary diagnosis coding |
| Practice Management | 10-15% | - Accounts receivable management - Insurance verification processes - Collections and payment posting - Patient registration and demographics - Patient responsibility calculations |
| Healthcare Billing Fundamentals | 15-20% | - Revenue cycle overview - Medical terminology basics - Anatomy and physiology for billers - Healthcare documentation principles |
| CPT Coding | 20-25% | - CPT code categories and structure - Surgical procedure codes - Modifiers and their appropriate use - Evaluation and Management (E/M) codes - Category II and III codes |
AAPC Certified Professional Biller (CPB) Sample Questions:
HHRG stands for Home Health Resource Group.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
ilio
- A. ilium (hip bone)
- B. in, into, not
- C. between
- D. within, into
Correct Answer: A 🗳️
HRA stands for Health Reimbursement Arrangement.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
FMAP stands for Federal Medical Assistance Percentage.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
What does HMO stand for?
- A. Health Maintenance Organization
- B. Health Management Organization
- C. Hospital Management Organization
- D. Hospital Monitoring Organization
Correct Answer: A 🗳️
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