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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Practice Management | 10-15% | - Collections and payment posting - Patient responsibility calculations - Insurance verification processes - Accounts receivable management - Patient registration and demographics |
| Topic 2: Billing Compliance and Regulations | 10-15% | - Stark Law and Anti-Kickback Statute basics - Documentation compliance - HIPAA privacy and security requirements - Appeal and denial management - Fraud, waste, and abuse prevention |
| Topic 3: Insurance and Reimbursement | 20-25% | - Commercial insurance policies - Fee schedules and reimbursement methodologies - Coordination of benefits - Claims submission and processing - Workers' compensation and no-fault billing - Government payers (Medicare, Medicaid, TRICARE) |
| Topic 4: ICD-10-CM Diagnosis Coding | 15-20% | - Secondary diagnosis coding - Code accuracy and specificity - Principal diagnosis selection - ICD-10-CM structure and conventions - Chapter-specific guidelines |
| Topic 5: CPT Coding | 20-25% | - Surgical procedure codes - Category II and III codes - Modifiers and their appropriate use - CPT code categories and structure - Evaluation and Management (E/M) codes |
| Topic 6: Healthcare Billing Fundamentals | 15-20% | - Medical terminology basics - Healthcare documentation principles - Anatomy and physiology for billers - Revenue cycle overview |
AAPC Certified Professional Biller (CPB) Sample Questions:
Question 1
HAVEN stands for Home Assessment Validation and Entry.
A. TRUE
B. FALSE
Question 2
What are Category II 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. 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.
C. Procedures/ services identified by a five digit CPT code and descriptor nomenclature; these codes are traditionally associated with CPT and organized within six sections.
Question 3
The medical word root "hyster" or "hyster/o" refers to the:
A. condition
B. pertaining to
C. uterus, womb
Question 4
Advance Beneficiary Notice (ABN) is document that acknowledges patient responsibility for payment if Medicare denies the claim.
A. TRUE
B. FALSE
Question 5
Which of the following suffixes refers to out?
A. en
B. infra
C. end, endo
D. ex
Solutions:
| Question 1 Answer: A | Question 2 Answer: A | Question 3 Answer: C | Question 4 Answer: A | Question 5 Answer: D |
Evan 
Arlene 
Julia 
Kim 
Nelly 
Jerry 
Justin 
Kerwin 
Justin 
Isidore 
Jo 
Merle 
Octavia 
Isaac 
