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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Case Analysis | 17% | - Adjudication and resolution - Eligibility verification - End-to-end billing scenarios |
| Topic 2: Types of Insurance | 21% | - TRICARE/CHAMPUS, Workers' compensation - Managed care plans - Medicare, Medigap, Medicaid - Commercial payers - Third-party liability |
| Topic 3: Reimbursement and Collections | 14% | - Accounts receivable management - Patient statements, collections - Payment posting, adjustments - Refunds, payment plans, write-offs |
| Topic 4: Claims and Billing | 14% | - Timely filing rules - Electronic claims, clearinghouses - Claim submission, tracking, follow-up - Denials, appeals, corrections |
| Topic 5: Billing Regulations | 13% | - ACOs, NCCI, LCDs, NCDs - Incident-to billing, global packages - Payer payment policies - CMS-1500, UB-04 completion |
| Topic 6: HIPAA and Compliance | 9% | - Fraud, abuse, False Claims Act - Medical record retention - Compliance programs - Privacy, security, transaction standards |
| Topic 7: Coding Concepts for Billers | 12% | - Code validation, modifiers - ICD-10-CM, CPT®, HCPCS Level II - Medical necessity |
AAPC Certified Professional Biller (CPB) Sample Questions:
Question #1
CNS
A. Coordination of Benefits
B. Certified Professional Coder
C. Consolidated Omnibus Budget Reconciliation Act of 1985
D. Clinical nurse specialist
Question #2
iasis
A. eyelid
B. condition
C. two
D. short
Question #3
FEHBP stands for Federal Employee Health Benefit Program.
A. FALSE
B. TRUE
Question #4
What does it mean by itis?
A. edema
B. infection
C. inflammation
D. swelling
Question #5
Care plan oversight services cover the physician's time supervising a complex and multidisciplinary care treatment program for specific patient who is under the care of a home health agency, hospice, or nursing facility.
A. FALSE
B. TRUE
Solutions:
| Question #1 Correct Answer: D | Question #2 Correct Answer: B | Question #3 Correct Answer: B | Question #4 Correct Answer: C | Question #5 Correct Answer: B |
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