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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
| Practice Management | 10-15% | - Insurance verification processes
- Collections and payment posting
- Accounts receivable management
- Patient responsibility calculations
- Patient registration and demographics
|
| 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
|
| Healthcare Billing Fundamentals | 15-20% | - Healthcare documentation principles
- Revenue cycle overview
- Medical terminology basics
- Anatomy and physiology for billers
|
| Insurance and Reimbursement | 20-25% | - Fee schedules and reimbursement methodologies
- Government payers (Medicare, Medicaid, TRICARE)
- Commercial insurance policies
- Workers' compensation and no-fault billing
- Coordination of benefits
- Claims submission and processing
|
| Billing Compliance and Regulations | 10-15% | - HIPAA privacy and security requirements
- Appeal and denial management
- Documentation compliance
- Stark Law and Anti-Kickback Statute basics
- Fraud, waste, and abuse prevention
|
| CPT Coding | 20-25% | - Evaluation and Management (E/M) codes
- Category II and III codes
- Modifiers and their appropriate use
- Surgical procedure codes
- CPT code categories and structure
|
AAPC Certified Professional Biller (CPB) Sample Questions:
1. The medical prefixes "hypo-" or "hyp-" mean:
A) below, under
B) above, excessive
C) condition
D) uterus, womb
2. What does it mean by angi?
A) artery
B) vessel
C) vein
3. Blue Cross Blue Shield Association (BCBSA) is an association of independent Blue Cross Blue Shield plans.
A) TRUE
B) FALSE
4. What does it mean by ipsi?
A) same
B) different
5. Which professional association was founded to improve the quality of medical records and current advances toward an electronic and global environment including the implementation of ICD10CM
A) American Academy of Professional Coders (AAPC)
B) Joint venture between Blue Cross and Blue shield where the corporations shared one building and computer services but maintained separate corporate identities
C) American Health Information Management Association (AHIMA)
D) An association of independent Blue Cross Blue Shield plans
Solutions:
Question # 1 Answer: A | Question # 2 Answer: B | Question # 3 Answer: A | Question # 4 Answer: A | Question # 5 Answer: C |