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AAPC CPB Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Billing Regulations13%- CMS-1500, UB-04 completion
- ACOs, NCCI, LCDs, NCDs
- Incident-to billing, global packages
- Payer payment policies
Topic 2: HIPAA and Compliance9%- Fraud, abuse, False Claims Act
- Privacy, security, transaction standards
- Compliance programs
- Medical record retention
Topic 3: Coding Concepts for Billers12%- ICD-10-CM, CPT®, HCPCS Level II
- Medical necessity
- Code validation, modifiers
Topic 4: Case Analysis17%- Adjudication and resolution
- Eligibility verification
- End-to-end billing scenarios
Topic 5: Reimbursement and Collections14%- Payment posting, adjustments
- Accounts receivable management
- Patient statements, collections
- Refunds, payment plans, write-offs
Topic 6: Claims and Billing14%- Electronic claims, clearinghouses
- Timely filing rules
- Denials, appeals, corrections
- Claim submission, tracking, follow-up
Topic 7: Types of Insurance21%- Third-party liability
- Commercial payers
- Medicare, Medigap, Medicaid
- TRICARE/CHAMPUS, Workers' compensation
- Managed care plans

AAPC Certified Professional Biller (CPB) Sample Questions:

1. What does it mean by brady?

A) fast
B) slow


2. APDRG refers to All Patient DiagnosisRelated Group.

A) TRUE
B) FALSE


3. American Association of Medical Assistants (AAMA) enables medical assisting professionals to enhance and demonstrate the knowledge, skills, and professionalism required by employers and patients; as well as protect medical assistants' right to practice.

A) TRUE
B) FALSE


4. Which payer typically requires prior authorization for certain services?

A) All payers equally
B) Commercial and managed care plans
C) Only Medicare
D) Medicaid only


5. anti

A) joint
B) condition
C) against


Solutions:

Question # 1
Answer: B
Question # 2
Answer: A
Question # 3
Answer: A
Question # 4
Answer: B
Question # 5
Answer: C

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