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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Reimbursement and Collections | 14% | - Patient statements, collections - Refunds, payment plans, write-offs - Payment posting, adjustments - Accounts receivable management |
| Case Analysis | 17% | - Adjudication and resolution - End-to-end billing scenarios - Eligibility verification |
| Coding Concepts for Billers | 12% | - Medical necessity - Code validation, modifiers - ICD-10-CM, CPT®, HCPCS Level II |
| Billing Regulations | 13% | - Incident-to billing, global packages - CMS-1500, UB-04 completion - ACOs, NCCI, LCDs, NCDs - Payer payment policies |
| Claims and Billing | 14% | - Denials, appeals, corrections - Timely filing rules - Electronic claims, clearinghouses - Claim submission, tracking, follow-up |
| HIPAA and Compliance | 9% | - Privacy, security, transaction standards - Compliance programs - Fraud, abuse, False Claims Act - Medical record retention |
| Types of Insurance | 21% | - Commercial payers - Medicare, Medigap, Medicaid - Managed care plans - TRICARE/CHAMPUS, Workers' compensation - Third-party liability |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. Which professional association was founded to elevate the standards of medical coding by providing certification, ongoing education, networking, and recognition for coders?
A) American Academy of Professional Coders (AAPC)
B) American Health Information Management Association (AHIMA)
C) An association of independent Blue Cross Blue Shield plans
D) Joint venture between Blue Cross and Blue shield where the corporations shared one building and computer services but maintained separate corporate identities
2. What does CDHS stand for?
A) Colorado Department of Health Services
B) Connecticut Department of Health Services
C) California Department of Health Services
3. extra
A) milk
B) before
C) outside
D) fiber
4. What does CCS stand for?
A) Certified Coding Services
B) Certified Coding Specialist
C) Certified Coding Standards
5. abdomin
A) extremities, top
B) toward
C) abdomen
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: C | Question # 3 Answer: C | Question # 4 Answer: B | Question # 5 Answer: C |
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