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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Insurance and Reimbursement | 20-25% | - Fee schedules and reimbursement methodologies - Workers' compensation and no-fault billing - Commercial insurance policies - Claims submission and processing - Coordination of benefits - Government payers (Medicare, Medicaid, TRICARE) |
| ICD-10-CM Diagnosis Coding | 15-20% | - ICD-10-CM structure and conventions - Secondary diagnosis coding - Code accuracy and specificity - Principal diagnosis selection - Chapter-specific guidelines |
| Practice Management | 10-15% | - Accounts receivable management - Collections and payment posting - Patient responsibility calculations - Patient registration and demographics - Insurance verification processes |
| CPT Coding | 20-25% | - Category II and III codes - CPT code categories and structure - Modifiers and their appropriate use - Surgical procedure codes - Evaluation and Management (E/M) codes |
| Healthcare Billing Fundamentals | 15-20% | - Medical terminology basics - Revenue cycle overview - Healthcare documentation principles - Anatomy and physiology for billers |
| Billing Compliance and Regulations | 10-15% | - Appeal and denial management - HIPAA privacy and security requirements - Fraud, waste, and abuse prevention - Documentation compliance - Stark Law and Anti-Kickback Statute basics |
AAPC Certified Professional Biller (CPB) Sample Questions:
FECA stands for Federal Employment Compensation Act.
- A. TRUE
- B. FALSE
What does the acronym EHR stand for?
- A. Evaluation and Management
- B. Electronic Medical Record
- C. Electronic Health Record
- D. Electronic Media Claim
What does it mean by intra and intro?
- A. within, into
- B. without
Which part of the body does cardi refer to?
- A. neck
- B. head
- C. heart
- D. vagina
The medical word root "hemat" or "hemat/o" refers to:
- A. liver
- B. blood
- C. below, under
- D. half
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