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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Practice Management | 10-15% | - Patient responsibility calculations - Patient registration and demographics - Accounts receivable management - Insurance verification processes - Collections and payment posting |
| Topic 2: Billing Compliance and Regulations | 10-15% | - HIPAA privacy and security requirements - Documentation compliance - Appeal and denial management - Stark Law and Anti-Kickback Statute basics - Fraud, waste, and abuse prevention |
| Topic 3: Healthcare Billing Fundamentals | 15-20% | - Revenue cycle overview - Anatomy and physiology for billers - Healthcare documentation principles - Medical terminology basics |
| Topic 4: 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 |
| Topic 5: ICD-10-CM Diagnosis Coding | 15-20% | - Principal diagnosis selection - Secondary diagnosis coding - ICD-10-CM structure and conventions - Code accuracy and specificity - Chapter-specific guidelines |
| Topic 6: Insurance and Reimbursement | 20-25% | - Government payers (Medicare, Medicaid, TRICARE) - Commercial insurance policies - Coordination of benefits - Claims submission and processing - Workers' compensation and no-fault billing - Fee schedules and reimbursement methodologies |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. abdomin
A) abdomen
B) toward
C) extremities, top
2. What does it mean by angi?
A) vein
B) artery
C) vessel
3. What does it mean by cyan?
A) red
B) green
C) yellow
D) blue
4. What are Category III codes?
A) Optional performance measurement tracking codes that are field (e,g.,1234A); these codes will be located after the medicine section; their use is optional.
B) Procedures/ services identified by a five digit CPT code and descriptor nomenclature; these codes are traditionally associated with CPT and organized within six sections.
C) Temporary codes for data collection purposes that are assigned an alphanumeric identifier with a letter in the last field (e.g., 0001T) these codes are located after the Medicine section, and will be archived after five years unless accepted for placement within Category I sections of CPT.
5. What are Category I Codes?
A) Optional performance measurement tracking codes that are assigned an alphanumeric identifier with a letter in the last field (e,g.,1234A); these codes will be located after the medicine section; their use is optional.
B) Procedures/ services identified by a five digit CPT code and descriptor nomenclature; these codes are traditionally associated with CPT and organized within six sections.
C) Temporary codes for data collection purposes that are assigned an alphanumeric identifier with a letter in the last field (e.g., 0001T) these codes are located after the Medicine section, and will be archived after five years unless accepted for placement within Category I sections of CPT.
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: C | Question # 3 Answer: D | Question # 4 Answer: C | Question # 5 Answer: B |
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