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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Insurance and Reimbursement | 20-25% | - Coordination of benefits - Government payers (Medicare, Medicaid, TRICARE) - Commercial insurance policies - Claims submission and processing - Workers' compensation and no-fault billing - Fee schedules and reimbursement methodologies |
| Billing Compliance and Regulations | 10-15% | - Documentation compliance - Stark Law and Anti-Kickback Statute basics - Appeal and denial management - HIPAA privacy and security requirements - Fraud, waste, and abuse prevention |
| Healthcare Billing Fundamentals | 15-20% | - Revenue cycle overview - Healthcare documentation principles - Medical terminology basics - Anatomy and physiology for billers |
| ICD-10-CM Diagnosis Coding | 15-20% | - Secondary diagnosis coding - Code accuracy and specificity - Principal diagnosis selection - Chapter-specific guidelines - ICD-10-CM structure and conventions |
| Practice Management | 10-15% | - Accounts receivable management - Patient registration and demographics - Patient responsibility calculations - Insurance verification processes - Collections and payment posting |
| CPT Coding | 20-25% | - Category II and III codes - Modifiers and their appropriate use - Surgical procedure codes - Evaluation and Management (E/M) codes - CPT code categories and structure |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. contra
A) against, opposite
B) blue
C) cold
D) skull
2. The medical word root "eti" (or "eti/o") refers to:
A) outside
B) fiber
C) out, away from
D) cause
3. What does it mean by graphy?
A) process of publishing
B) process of recording
4. Which amount is written off when a provider is contracted with an insurance company?
A) Deductible
B) Copayment
C) Contractual adjustment
D) Allowed amount
5. The word root "acr" (or "acro-") refers to:
A) fat
B) toward
C) extremities, top
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: D | Question # 3 Answer: B | Question # 4 Answer: C | Question # 5 Answer: C |
Jim 
Barbara 
Beatrice 
Hubery 
Cliff 
Thera 
Cornell 
Hunter 
Hubery 
Patricia 
August 
Beulah 
Levi 
Harlan 
Jeffrey 
Reg 
