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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| ICD-10-CM Diagnosis Coding | 15-20% | - Secondary diagnosis coding - Chapter-specific guidelines - ICD-10-CM structure and conventions - Code accuracy and specificity - Principal diagnosis selection |
| Practice Management | 10-15% | - Insurance verification processes - Patient responsibility calculations - Collections and payment posting - Accounts receivable management - Patient registration and demographics |
| Insurance and Reimbursement | 20-25% | - Coordination of benefits - Government payers (Medicare, Medicaid, TRICARE) - Fee schedules and reimbursement methodologies - Workers' compensation and no-fault billing - Claims submission and processing - Commercial insurance policies |
| CPT Coding | 20-25% | - Category II and III codes - Surgical procedure codes - CPT code categories and structure - Evaluation and Management (E/M) codes - Modifiers and their appropriate use |
| Healthcare Billing Fundamentals | 15-20% | - Healthcare documentation principles - Medical terminology basics - Anatomy and physiology for billers - Revenue cycle overview |
| Billing Compliance and Regulations | 10-15% | - Stark Law and Anti-Kickback Statute basics - Fraud, waste, and abuse prevention - Appeal and denial management - Documentation compliance - HIPAA privacy and security requirements |
AAPC Certified Professional Biller (CPB) Sample Questions:
Question 1
FMAP stands for Federal Medical Assistance Percentage.
A. FALSE
B. TRUE
Question 2
extra
A. milk
B. fiber
C. before
D. outside
Question 3
FEP stands for Federal Employee Program.
A. FALSE
B. TRUE
Question 4
GEP stands for General Enrollment Period.
A. FALSE
B. TRUE
Question 5
Care plan oversight services cover the physician's time supervising a complex and multidisciplinary care treatment program for specific patient who is under the care of a home health agency, hospice, or nursing facility.
A. FALSE
B. TRUE
Solutions:
| Question 1 Answer: B | Question 2 Answer: D | Question 3 Answer: B | Question 4 Answer: B | Question 5 Answer: B |
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