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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Insurance and Reimbursement | 20-25% | - Coordination of benefits - Workers' compensation and no-fault billing - Commercial insurance policies - Fee schedules and reimbursement methodologies - Claims submission and processing - Government payers (Medicare, Medicaid, TRICARE) |
| ICD-10-CM Diagnosis Coding | 15-20% | - ICD-10-CM structure and conventions - Secondary diagnosis coding - Principal diagnosis selection - Chapter-specific guidelines - Code accuracy and specificity |
| Billing Compliance and Regulations | 10-15% | - Stark Law and Anti-Kickback Statute basics - HIPAA privacy and security requirements - Appeal and denial management - Documentation compliance - Fraud, waste, and abuse prevention |
| Healthcare Billing Fundamentals | 15-20% | - Anatomy and physiology for billers - Healthcare documentation principles - Revenue cycle overview - Medical terminology basics |
| Practice Management | 10-15% | - Insurance verification processes - Patient registration and demographics - Patient responsibility calculations - Accounts receivable management - Collections and payment posting |
| CPT Coding | 20-25% | - Evaluation and Management (E/M) codes - Surgical procedure codes - Category II and III codes - Modifiers and their appropriate use - CPT code categories and structure |
AAPC Certified Professional Biller (CPB) Sample Questions:
Question 1
What does it mean by cyan?
A. green
B. red
C. yellow
D. blue
Question 2
What does BC stand for?
A. Beneficiary Counseling
B. Black Cross
C. Blue Cross
D. Beneficiary Association
Question 3
What does the acronym CT stand for?
A. Computed Tomography
B. Debt Collection Assistance Officer
C. Defense Enrollment Eligibility Reporting System
D. Durable Medical Equipment
Question 4
Which scenario would most likely result in a claim denial for lack of medical necessity?
A. Missing modifier
B. Incorrect patient demographics
C. Diagnosis code does not support the procedure
D. Late filing
Question 5
The medical word root "hyster" or "hyster/o" refers to the:
A. condition
B. uterus, womb
C. pertaining to
Solutions:
| Question 1 Answer: D | Question 2 Answer: C | Question 3 Answer: A | Question 4 Answer: C | Question 5 Answer: B |
Burgess 
Ternence 
Parker 
Alice 
Arnold 
Broderick 
Priscilla 
Celeste 
Joa 
Susan 
Marjorie 
Geraldine 
Clement 
Edgar 
Hedy 
